Provider Demographics
NPI:1316044878
Name:ALFINO, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:ALFINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4423 NW 6TH PLACE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-6115
Mailing Address - Country:US
Mailing Address - Phone:352-377-5600
Mailing Address - Fax:352-377-0995
Practice Address - Street 1:4423 NW 6TH PLACE
Practice Address - Street 2:SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-6115
Practice Address - Country:US
Practice Address - Phone:352-377-5600
Practice Address - Fax:352-377-0995
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50253207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD50690Medicare UPIN
FL02950ZMedicare ID - Type UnspecifiedMEDICARE #