Provider Demographics
NPI:1750013827
Name:BAR, ALON (MD)
Entity Type:Individual
Prefix:MR
First Name:ALON
Middle Name:
Last Name:BAR
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 1:1611 NW 12 AVENUE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136
Mailing Address - Country:US
Mailing Address - Phone:305-585-1293
Mailing Address - Fax:305-585-6043
Practice Address - Street 1:1611 NW 12 AVENUE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-585-1293
Practice Address - Fax:305-585-6043
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2023-04-06
Deactivation Date:2023-03-20
Deactivation Code:
Reactivation Date:2023-04-06
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program