Provider Demographics
NPI:1356315485
Name:ALONSO-LLAMAZARES, JAVIER (MDPHD)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:ALONSO-LLAMAZARES
Suffix:
Gender:M
Credentials:MDPHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 BILTMORE WAY STE 308
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5749
Mailing Address - Country:US
Mailing Address - Phone:305-443-9725
Mailing Address - Fax:
Practice Address - Street 1:475 BILTMORE WAY STE 308
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5749
Practice Address - Country:US
Practice Address - Phone:305-443-2983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97488207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP00203390Medicare ID - Type UnspecifiedRAILROAD
I16033Medicare UPIN