Provider Demographics
NPI:1811934409
Name:ALFONSO, CALIXTO JR (DC)
Entity type:Individual
Prefix:
First Name:CALIXTO
Middle Name:
Last Name:ALFONSO
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8660 W FLAGLER ST STE 215
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2061
Mailing Address - Country:US
Mailing Address - Phone:305-228-6845
Mailing Address - Fax:
Practice Address - Street 1:8660 W FLAGLER ST STE 215
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2061
Practice Address - Country:US
Practice Address - Phone:305-228-6845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6680111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor