Provider Demographics
NPI:1669873899
Name:ALONZO, ANDREW QUIROGA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:QUIROGA
Last Name:ALONZO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11921 BOURNEFIELD WAY
Mailing Address - Street 2:SUITE D
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7815
Mailing Address - Country:US
Mailing Address - Phone:301-879-5509
Mailing Address - Fax:
Practice Address - Street 1:11921 BOURNEFIELD WAY
Practice Address - Street 2:SUITE D
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7815
Practice Address - Country:US
Practice Address - Phone:301-879-5509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20691183500000X
VA0202211424183500000X
DCPH100001426183500000X
CA68455183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202211424OtherVIRGINIA BOARD OF PHARMACY PHARMACIST LICENSE
DCPH100001426OtherDISTRICT OF COLUMBIA BOARD OF PHARMACY PHARMACIST LICENSE
MD20691OtherMARYLAND BOARD OF PHARMACY PHARMACIST LICENSE
CA68455OtherCALIFORNIA BOARD OF PHARMACY PHARMACIST LICENSE