Healthcare Provider Details

I. General information

NPI: 1346174141
Provider Name (Legal Business Name): LAURA BEATRIZ ALONSO HECTOR DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 N US HIGHWAY 27 STE A
LADY LAKE FL
32159-3108
US

IV. Provider business mailing address

3100 SW 35TH PL APT 10G
GAINESVILLE FL
32608-2679
US

V. Phone/Fax

Practice location:
  • Phone: 352-282-4785
  • Fax:
Mailing address:
  • Phone: 305-870-3922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN31824
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: