# MARTHA N ALFONSO O.D.P.A

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326340365
- **Authorized official:** MARTHA N ALFONSO (OPTOMETRIST)
- **Authorized official phone:** (305) 463-8032

## Contact information

- **Practice address:** 366 E 4TH AVE, HIALEAH, FL 33010-4998
- **Practice address phone:** (305) 888-9910
- **Mailing address:** 11476 NW 81ST TER, MIAMI, FL 33178-1487
- **Mailing address phone:** (305) 463-8032
- **Mailing address fax:** (786) 360-4907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 3313 | FL | Yes |

## Other

- **Enumeration date:** 11/24/2010
- **Last updated:** 11/24/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 620507100 | — | FL |