Healthcare Provider Details

I. General information

NPI: 1871655639
Provider Name (Legal Business Name): ALINA MARIA ALONSO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 08/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CLEMATIS ST STE 5-531
WEST PALM BEACH FL
33401
US

IV. Provider business mailing address

800 CLEMATIS ST STE 5-531
WEST PALM BEACH FL
33401-5107
US

V. Phone/Fax

Practice location:
  • Phone: 561-671-4043
  • Fax: 561-837-5190
Mailing address:
  • Phone: 561-671-4043
  • Fax: 561-837-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME55660
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: