Provider Demographics
NPI:1346366218
Name:ALFONSO, NIUVIS (CPHT)
Entity Type:Individual
Prefix:MS
First Name:NIUVIS
Middle Name:
Last Name:ALFONSO
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1116
Mailing Address - Country:US
Mailing Address - Phone:305-898-1451
Mailing Address - Fax:
Practice Address - Street 1:5989 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5037
Practice Address - Country:US
Practice Address - Phone:305-265-3738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2201-1020-3521-63183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician