Provider Demographics
NPI:1346360369
Name:ALFONSO, ORLANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ORLANDO
Middle Name:
Last Name:ALFONSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7080 SW 107TH ST
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-3587
Mailing Address - Country:US
Mailing Address - Phone:786-374-4329
Mailing Address - Fax:
Practice Address - Street 1:7080 SW 107TH ST
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-3587
Practice Address - Country:US
Practice Address - Phone:786-374-4329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103044207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine