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NPI Code Detail

MEDICARE: DR. CAMILLE MARIE ALFONSO D.O.

MEDICARE: DR. CAMILLE MARIE ALFONSO D.O.
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
1207R00000XInternal Medicine PhysicianOS14353FL
2208M00000XHospitalist PhysicianOS14353FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912312794
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAMILLE MARIE ALFONSO D.O.
Provider Business Mailing Address
First Line : 2995 DREW ST FL 2
Second Line :
City : CLEARWATER
State : FL
Zip : 33759-3012
Country : US
Telephone Number : 727-532-0002
Fax Number : 813-870-4887
Provider Business Practice Location Address
First Line : 3001 W DR MARTIN LUTHER KING JR BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33607-6307
Country : US
Telephone Number : 813-870-4933
Fax Number : 813-870-4887
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2014
Last Update Date : 02/03/2026

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