Provider Demographics
NPI:1770937955
Name:ALFONSO REMIGIO, ABRAHAM (MD)
Entity type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:
Last Name:ALFONSO REMIGIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 CASTLEGATE AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3263
Mailing Address - Country:US
Mailing Address - Phone:305-492-3744
Mailing Address - Fax:
Practice Address - Street 1:730 SE 8TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5660
Practice Address - Country:US
Practice Address - Phone:305-492-3744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME137116207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine