Individual provider · NPI-1

Alfonso Alfonso, RN

Registered Nurse, Psych/Mental Health · Doral, FL

NPI number1679234041
StatusActive
Last updated in NPPESJan 6, 2022

Details

NPI
1679234041
Entity type
Individual (NPI-1)
Name
Alfonso Alfonso
Credential
RN
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 6, 2022
Certification date
Jan 6, 2022
Last updated
Jan 6, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WP0808X Registered Nurse, Psych/Mental HealthRN9248794FLYes
163WG0000X Registered Nurse, General PracticeRN9248794FL
163WP0000X Registered Nurse, Pain ManagementRN9248794FL

Practice location

2500 Nw 79th Ave Ste 227
Doral, FL 33122-1085

Phone 305-456-9396 · Fax 786-796-0640

Mailing address

2500 Nw 79th Ave Ste 227
Doral, FL 33122-1085

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