Healthcare Provider Details

I. General information

NPI: 1699142687
Provider Name (Legal Business Name): ALEJANDRO SERRALVO FUENTES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2015
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 W 34TH ST
HIALEAH FL
33012-4309
US

IV. Provider business mailing address

9240 SW 72ND ST STE 238
MIAMI FL
33173-3264
US

V. Phone/Fax

Practice location:
  • Phone: 305-823-3312
  • Fax: 786-360-2327
Mailing address:
  • Phone: 305-315-8289
  • Fax: 305-503-8297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME134750
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: