Provider Demographics
NPI:1639282601
Name:ALAMO, ALDO (MD)
Entity Type:Individual
Prefix:
First Name:ALDO
Middle Name:
Last Name:ALAMO
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 1:1309 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2040
Mailing Address - Country:US
Mailing Address - Phone:954-463-4383
Mailing Address - Fax:954-463-3904
Practice Address - Street 1:1309 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2040
Practice Address - Country:US
Practice Address - Phone:954-463-4383
Practice Address - Fax:954-463-3904
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64528207R00000X
VA0101243615207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1639282601Medicaid
VAP00637886OtherMEDICARE RAILROAD
FL376388900Medicaid
VAMC10541Medicare PIN
VAMC12375Medicare PIN
VAP00679649Medicare PIN
VAP00637886OtherMEDICARE RAILROAD
VAF88743Medicare UPIN
FL376388900Medicaid