Provider Demographics
NPI:1134224041
Name:ALONZO, GILDA F (DDS)
Entity type:Individual
Prefix:DR
First Name:GILDA
Middle Name:F
Last Name:ALONZO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 W INDIANTOWN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7546
Mailing Address - Country:US
Mailing Address - Phone:561-747-3338
Mailing Address - Fax:561-747-9133
Practice Address - Street 1:654 W INDIANTOWN RD STE 102
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7546
Practice Address - Country:US
Practice Address - Phone:561-747-3338
Practice Address - Fax:561-747-9133
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN132591223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL075012300Medicaid
FLDN13259OtherLICENSE NUMBER
FLDN13259OtherLICENSE NUMBER
FL075012300Medicaid