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Individual

OCTAVIO MIGUEL ALFONSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NURSE PRACTITIONER

Contact information

Practice address
1951 NW 7TH AVE STE 300, MIAMI, FL 33136-1112
(305) 902-6347
(727) 306-8033
Mailing address
7950 NW 53RD ST STE 337, MIAMI, FL 33166-4791
(305) 901-4344
(866) 480-9591

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
ARNP9243092
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
9243092
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN9243092
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
109440600
FL
Enumeration date
12/22/2017
Last updated
09/11/2021
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