# LESLIE R ALONZO III

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

## Provider details

- **NPI number:** 1598762395
- **Gender:** Man
- **Credential:** O.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC2323 | FL | Yes |

## Other

- **Enumeration date:** 07/07/2005
- **Last updated:** 09/11/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 078635700 | — | FL |
| 01 | — | 19254 | BCBS FLORIDA | FL |
| 01 | — | 2074336 | AETNA | FL |
| 01 | — | 4388598 | AETNA | FL |
| 01 | — | 6500152 | GHI | FL |