Healthcare Provider Details

I. General information

NPI: 1184653206
Provider Name (Legal Business Name): EDILIA ALZUGARAY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 NE 2ND AVE
MIAMI FL
33137-2706
US

IV. Provider business mailing address

5200 NE 2ND AVE
MIAMI FL
33137-2706
US

V. Phone/Fax

Practice location:
  • Phone: 305-751-8626
  • Fax: 305-762-1488
Mailing address:
  • Phone: 305-751-8626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME77526
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: