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General NPI Number Information
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NPI Number | 1033298393
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Entity Type | Individual
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Provider Name | MAYRA I ALFONSO MD
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 4847 DAVID S MACK DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-8023
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Country | US
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Telephone | 561-687-4958
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Fax |
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Provider Business Mailing Address
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Address Line | 8221 NADMAR AVE
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City | BOCA RATON
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State | FL
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Zip | 33434-6306
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Country | US
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Telephone | 727-748-7860
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME114962
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License Number State | FL
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