Provider Demographics
NPI:1427004548
Name:DOSDOS, ALFREDO REYES (MD)
Entity Type:Individual
Prefix:
First Name:ALFREDO
Middle Name:REYES
Last Name:DOSDOS
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 1:107 JFK DR
Mailing Address - Street 2:STE B
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1153
Mailing Address - Country:US
Mailing Address - Phone:561-295-6962
Mailing Address - Fax:561-249-2512
Practice Address - Street 1:5401 S CONGRESS AVE
Practice Address - Street 2:# 201
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6635
Practice Address - Country:US
Practice Address - Phone:561-641-7848
Practice Address - Fax:561-641-6985
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55592207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL61828400Medicaid
FL61828400Medicaid
FL09445Medicare PIN