Provider Demographics
NPI:1568496685
Name:ALLONGO, JOSE F JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:F
Last Name:ALLONGO
Suffix:JR
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 1:15760 WEATHERLY RD
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-8307
Mailing Address - Country:US
Mailing Address - Phone:561-790-5666
Mailing Address - Fax:561-790-5668
Practice Address - Street 1:13005 SOUTHERN BLVD
Practice Address - Street 2:SUITE 241
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9206
Practice Address - Country:US
Practice Address - Phone:561-790-5666
Practice Address - Fax:561-790-5668
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0041459207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373162600Medicaid
FLD57237Medicare UPIN
FL373162600Medicaid