MEDICARE: AMANDA I ALONSO MSN, FNP-C

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	363LF0000X	Family Nurse Practitioner	RN9426965	FL

General Provider Information

NPI Number	:	1194160085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA I ALONSO MSN, FNP-C

Provider Business Mailing Address
First Line	:	19120 NW 10TH ST
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-2929
Country	:	US
Telephone Number	:	305-794-4249
Fax Number	:

Provider Business Practice Location Address
First Line	:	19120 NW 10TH ST
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-2929
Country	:	US
Telephone Number	:	305-794-4249
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2013
Last Update Date	:	03/16/2026

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