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General NPI Number Information
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NPI Number | 1811776610
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Entity Type | Individual
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Provider Name | STEPHANIE ALFONSO-EVANS ACNPC-AG
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Gender | Female
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 7770 DAVIE ROAD EXT
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City | HOLLYWOOD
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State | FL
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Zip | 33024-2516
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Country | US
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Telephone | 954-450-1808
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Fax |
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Provider Business Mailing Address
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Address Line | 5120 THE OAKS CIR
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City | ORLANDO
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State | FL
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Zip | 32809-3051
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Country | US
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Telephone | 786-564-0063
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11028206
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License Number State | FL
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