Provider Demographics
NPI:1447241542
Name:MARCHANY-ALFONSO, LUIS ARNALDO (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ARNALDO
Last Name:MARCHANY-ALFONSO
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 1:2645 EXECUTIVE PARK DR STE 330
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3624
Mailing Address - Country:US
Mailing Address - Phone:954-751-4269
Mailing Address - Fax:954-686-2487
Practice Address - Street 1:2645 EXECUTIVE PARK DR STE 330
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3624
Practice Address - Country:US
Practice Address - Phone:954-751-4269
Practice Address - Fax:954-686-2487
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-30
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1349872084P0800X
PR16217208D00000X, 2084P0800X
NY239492390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program