Provider Demographics
NPI:1386225373
Name:DYNAMICTELE.MD
Entity Type:Organization
Organization Name:DYNAMICTELE.MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:JR
Authorized Official - Last Name:ALONZO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:305-316-4559
Mailing Address - Street 1:217 SE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-1901
Mailing Address - Country:US
Mailing Address - Phone:305-316-4559
Mailing Address - Fax:
Practice Address - Street 1:217 SE 1ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-1901
Practice Address - Country:US
Practice Address - Phone:305-316-4559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DYNAMICTELE.MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty