Provider Demographics
NPI:1275586836
Name:ALONSO, ZENAIDA MARIA (DDS)
Entity Type:Individual
Prefix:MISS
First Name:ZENAIDA
Middle Name:MARIA
Last Name:ALONSO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10549
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33733-0549
Mailing Address - Country:US
Mailing Address - Phone:727-824-8181
Mailing Address - Fax:
Practice Address - Street 1:702 JASMINE WAY
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-4086
Practice Address - Country:US
Practice Address - Phone:727-824-8181
Practice Address - Fax:727-216-7040
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15769122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002417100Medicaid
NY01632035Medicaid