=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477181576
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANABEL ALONSO MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/01/2020
-----------------------------------------------------
Last Update Date | 08/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14875 NW 77TH AVE
-----------------------------------------------------
City | MIAMI LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33014-2565
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-351-7109
-----------------------------------------------------
Fax | 305-824-0665
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14875 NW 77TH AVE
-----------------------------------------------------
City | MIAMI LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33014-2565
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-351-7109
-----------------------------------------------------
Fax | 305-824-0665
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number | ME163562
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207QH0002X
-----------------------------------------------------
Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number | ME163562
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------