Healthcare Provider Details

I. General information

NPI: 1487316691
Provider Name (Legal Business Name): LUIS M ALONSO HAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 10/14/2021
Certification Date: 10/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 SW 38TH ST
MIAMI FL
33165-3618
US

IV. Provider business mailing address

6532 SW 148TH CT
MIAMI FL
33193-2019
US

V. Phone/Fax

Practice location:
  • Phone: 305-225-5471
  • Fax:
Mailing address:
  • Phone: 305-498-4090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number4830
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number5594
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: