Provider Demographics
NPI:1013159763
Name:ALFONSO, BIANCA DORINA (MD)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:DORINA
Last Name:ALFONSO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6141 SUNSET DR STE 403
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5026
Mailing Address - Country:US
Mailing Address - Phone:305-665-2300
Mailing Address - Fax:305-669-8966
Practice Address - Street 1:6141 SUNSET DR STE 403
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5026
Practice Address - Country:US
Practice Address - Phone:305-665-2300
Practice Address - Fax:305-669-8966
Is Sole Proprietor?:No
Enumeration Date:2009-03-26
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 109946207RE0101X, 207RE0101X
NY242700207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL352405OtherAVMED
FLU006OOtherBCBS
FLFK506WOtherMEDICARE
FL14J35OtherBCBS
FL352405OtherAVMED