Healthcare Provider Details

I. General information

NPI: 1700775558
Provider Name (Legal Business Name): NELLY ALONSO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2025
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 SE 1ST ST
DELRAY BEACH FL
33483-4540
US

IV. Provider business mailing address

403 SE 1ST ST
DELRAY BEACH FL
33483-4540
US

V. Phone/Fax

Practice location:
  • Phone: 561-266-8866
  • Fax:
Mailing address:
  • Phone: 561-266-8866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11040254
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: