Healthcare Provider Details

I. General information

NPI: 1174553739
Provider Name (Legal Business Name): JOSEPH R. ALONSO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 08/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 SW 34TH ST
OCALA FL
34474-7422
US

IV. Provider business mailing address

3310 SW 34TH ST
OCALA FL
34474-7422
US

V. Phone/Fax

Practice location:
  • Phone: 352-861-9811
  • Fax: 352-873-3254
Mailing address:
  • Phone: 352-861-9811
  • Fax: 352-873-3254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME75635
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: