MEDICARE: ALEJANDRO CASUSO & GLADYS ALONSO MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician		FL

General Provider Information

NPI Number	:	1023050481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEJANDRO CASUSO & GLADYS ALONSO MD PA

Provider Business Mailing Address
First Line	:	1435 W 49TH PL
Second Line	:	SUITE 601
City	:	HIALEAH
State	:	FL
Zip	:	33012-3197
Country	:	US
Telephone Number	:	305-824-0224
Fax Number	:	305-824-0727

Provider Business Practice Location Address
First Line	:	1435 W 49TH PL
Second Line	:	SUITE 601
City	:	HIALEAH
State	:	FL
Zip	:	33012-3197
Country	:	US
Telephone Number	:	305-824-0224
Fax Number	:	305-824-0727

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ALEJANDRO CASUSO JR.
Credential	:
Telephone Number	:	305-824-0224

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	08/22/2020

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