Healthcare Provider Details

I. General information

NPI: 1023705084
Provider Name (Legal Business Name): ALONSO DANIEL ABUGATTAS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST STE 400
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

5524 ALBERT DR
WINTER PARK FL
32792-7510
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-5600
  • Fax:
Mailing address:
  • Phone: 813-580-6387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS23372
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: