Provider Demographics
NPI:1922377167
Name:BIANCA D. ALFONSO, M.D., P.A.
Entity Type:Organization
Organization Name:BIANCA D. ALFONSO, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALFONSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-632-8107
Mailing Address - Street 1:555 BILTMORE WAY STE 205
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5757
Mailing Address - Country:US
Mailing Address - Phone:305-445-3611
Mailing Address - Fax:
Practice Address - Street 1:555 BILTMORE WAY STE 205
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5757
Practice Address - Country:US
Practice Address - Phone:305-445-3611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME109946207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty