Healthcare Provider Details

I. General information

NPI: 1336120708
Provider Name (Legal Business Name): GUILLERMO N ALONSO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 W FLAGLER ST STE 206
MIAMI FL
33144-2153
US

IV. Provider business mailing address

3441 SW 134 COURT
MIAMI FL
33175-6944
US

V. Phone/Fax

Practice location:
  • Phone: 786-703-1620
  • Fax: 786-709-1619
Mailing address:
  • Phone: 305-227-5582
  • Fax: 305-227-4133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberME56063
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: