Physician Compare National (NPI:1093952442)

HEALTHCARE PROVIDER: JAVIER EMILIO ALFONSO M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1093952442
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6800063132
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120126000805
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ALFONSO
	Individual professional last name
Provider First Name	JAVIER
	Individual professional first name
Provider Middle Name	EMILIO
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	9240 BONITA BEACH RD SE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 2217
	Group Practice or individual's line 2 address
City	BONITA SPRINGS
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	341354251
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100154
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTH MIAMI HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100050
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	100284
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	WESTCHESTER GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y