Provider Demographics
NPI:1447584313
Name:ALONSO, BRANDON LEE (ARNP (MSN))
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:LEE
Last Name:ALONSO
Suffix:
Gender:M
Credentials:ARNP (MSN)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1215
Mailing Address - Country:US
Mailing Address - Phone:407-351-5384
Mailing Address - Fax:407-445-0321
Practice Address - Street 1:1222 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1215
Practice Address - Country:US
Practice Address - Phone:407-351-5384
Practice Address - Fax:407-445-0321
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9235467363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health