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General NPI Number Information
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NPI Number | 1760702351
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Entity Type | Individual
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Provider Name | MERCEDES N ALONSO
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Gender | Female
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 580 E 44 TH ST
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City | HIALEAH
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State | FL
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Zip | 33913-1914
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Country | US
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Telephone | 786-416-2467
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Fax | 305-512-4143
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Provider Business Mailing Address
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Address Line | 10470 W OKEECHOBEE RD APT 902
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City | HIALEAH
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State | FL
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Zip | 33018-1945
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Country | US
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Telephone | 786-416-2467
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Fax | 305-512-4143
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA57303
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 27523
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License Number State | FL
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