# MITZILENE ANNE ALFONSO TUAZON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1528402351
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 157598 | FL | — |
| 207Q00000X | Family Medicine Physician | 16533 | NV | Yes |
| 207QA0505X | Adult Medicine Physician | 157598 | FL | — |

## Other

- **Enumeration date:** 04/23/2013
- **Last updated:** 11/19/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | SMA MEDICARE | V114219 | NV |