Healthcare Provider Details

I. General information

NPI: 1477181576
Provider Name (Legal Business Name): ANABEL ALONSO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14875 NW 77TH AVE
MIAMI LAKES FL
33014-2565
US

IV. Provider business mailing address

14875 NW 77TH AVE
MIAMI LAKES FL
33014-2565
US

V. Phone/Fax

Practice location:
  • Phone: 305-351-7109
  • Fax: 305-824-0665
Mailing address:
  • Phone: 305-351-7109
  • Fax: 305-824-0665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberME163562
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberME163562
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: