Individual
ALFONSO ALFONSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2500 NW 79TH AVE STE 227, DORAL, FL 33122-1085
(305) 456-9396
(786) 796-0640
Mailing address
2500 NW 79TH AVE STE 227, DORAL, FL 33122-1085
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
RN9248794
FL
163WP0000X
Pain Management Registered Nurse
RN9248794
FL
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN9248794
FL
Other
Enumeration date
01/06/2022
Last updated
01/06/2022
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