Provider Demographics
NPI:1417033754
Name:ALZUGARAY, MANUEL A (MD)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:A
Last Name:ALZUGARAY
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 1:2340 CORAL WAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145
Mailing Address - Country:US
Mailing Address - Phone:305-858-7992
Mailing Address - Fax:305-858-8741
Practice Address - Street 1:2340 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145
Practice Address - Country:US
Practice Address - Phone:305-858-7992
Practice Address - Fax:305-858-8741
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-30
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0019606207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL055409000Medicaid
FL055409000Medicaid
FL92145Medicare ID - Type Unspecified