Provider Demographics
NPI:1770598641
Name:ALZUGARAY, SERGIO F (MD)
Entity type:Individual
Prefix:
First Name:SERGIO
Middle Name:F
Last Name:ALZUGARAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 351597
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-7597
Mailing Address - Country:US
Mailing Address - Phone:305-443-5031
Mailing Address - Fax:305-443-1336
Practice Address - Street 1:2140 W 68TH ST
Practice Address - Street 2:SUITE 204
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1815
Practice Address - Country:US
Practice Address - Phone:305-828-3997
Practice Address - Fax:305-828-4696
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2013-08-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME73697208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253617000Medicaid
FL42658Medicare PIN