Provider Demographics
NPI:1447241096
Name:PRADERE ALONSO, ALINA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALINA
Middle Name:
Last Name:PRADERE ALONSO
Suffix:
Gender:F
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:COND PARQ DE LAS FUENTES
Mailing Address - Street 2:APT 1406
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3901
Mailing Address - Country:US
Mailing Address - Phone:787-287-6377
Mailing Address - Fax:787-708-1728
Practice Address - Street 1:58 AVE ESMERALDA
Practice Address - Street 2:URB PONCE DE LEON
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4429
Practice Address - Country:US
Practice Address - Phone:787-287-6377
Practice Address - Fax:787-708-1728
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR7354207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR29540Medicare ID - Type Unspecified
PRE09037Medicare UPIN