Provider Demographics
NPI:1700978798
Name:ALONSO, CARLOS M
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:M
Last Name:ALONSO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14451 SW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-3114
Mailing Address - Country:US
Mailing Address - Phone:305-221-3774
Mailing Address - Fax:
Practice Address - Street 1:9445 SW 40TH ST
Practice Address - Street 2:SUITE 106
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-4001
Practice Address - Country:US
Practice Address - Phone:305-480-3737
Practice Address - Fax:305-480-3738
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS 2721237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist