MEDICARE: IVO ALONSO M.D

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	ME82269	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306839980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVO ALONSO M.D

Provider Business Mailing Address
First Line	:	3934 SW 8TH ST
Second Line	:	SUITE 207
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2949
Country	:	US
Telephone Number	:	305-448-7499
Fax Number	:	305-448-5061

Provider Business Practice Location Address
First Line	:	3934 SW 8TH ST
Second Line	:	SUITE 207
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2949
Country	:	US
Telephone Number	:	305-448-7499
Fax Number	:	305-448-5061

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

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	03/11/2008

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Directions to “ IVO ALONSO M.D” Practice Location

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