Provider Demographics
NPI:1356311922
Name:DUFRENY, ALPHONSE GILOUX (MD)
Entity Type:Individual
Prefix:
First Name:ALPHONSE
Middle Name:GILOUX
Last Name:DUFRENY
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 1:12 REDWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1942
Mailing Address - Country:US
Mailing Address - Phone:305-756-9392
Mailing Address - Fax:305-756-9392
Practice Address - Street 1:9999 NE 2ND AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2352
Practice Address - Country:US
Practice Address - Phone:305-756-9392
Practice Address - Fax:305-756-9392
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85072208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2671531ODMedicaid
FLE8696CMedicare PIN