Healthcare Provider Details

I. General information

NPI: 1811366719
Provider Name (Legal Business Name): ENRIQUE L. ROSARIO ALOMA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 E 25TH ST STE 112
HIALEAH FL
33013
US

IV. Provider business mailing address

777 E 25TH ST STE 112
HIALEAH FL
33013-3804
US

V. Phone/Fax

Practice location:
  • Phone: 305-696-3444
  • Fax:
Mailing address:
  • Phone: 305-696-3444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO3758
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: