Provider Demographics
NPI:1558646364
Name:ALONSO, YILIAN
Entity Type:Individual
Prefix:DR
First Name:YILIAN
Middle Name:
Last Name:ALONSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 WEST 50 ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:LA
Mailing Address - Zip Code:33012
Mailing Address - Country:US
Mailing Address - Phone:305-884-8774
Mailing Address - Fax:
Practice Address - Street 1:400 EAST HIALEAH DRIVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010
Practice Address - Country:US
Practice Address - Phone:305-884-8774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS44084183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist