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NPI Code Detail

MEDICARE: SOLYMAR ALFONZO

MEDICARE: SOLYMAR ALFONZO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1156FX1800XOpticianDO5039FL

General Provider Information

NPI Number : 1497448005
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOLYMAR ALFONZO
Provider Business Mailing Address
First Line : 3250 VINELAND RD
Second Line :
City : KISSIMMEE
State : FL
Zip : 34746-4893
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3250 VINELAND RD
Second Line :
City : KISSIMMEE
State : FL
Zip : 34746-4893
Country : US
Telephone Number : 407-397-1551
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2023
Last Update Date : 05/30/2023

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Directions to “ SOLYMAR ALFONZO ” Practice Location

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