Healthcare Provider Details

I. General information

NPI: 1194461699
Provider Name (Legal Business Name): DR. ALVIN CASAO ALEGADO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2022
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 SAINT JAMES AVE
GOOSE CREEK SC
29445-2938
US

IV. Provider business mailing address

PO BOX 880
FORT WASHINGTON PA
19034-0880
US

V. Phone/Fax

Practice location:
  • Phone: 843-797-5711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2435
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.007085
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number134554
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: