MEDICARE: MISS DAYNE ALONSO PA-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	363A00000X	Physician Assistant	PA9102974	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	:	1558312967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DAYNE ALONSO PA-C

Provider Business Mailing Address
First Line	:	10700 SW 106TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-3437
Country	:	US
Telephone Number	:	305-903-5636
Fax Number	:	305-402-5855

Provider Business Practice Location Address
First Line	:	5825 SW 117TH STREET
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33156
Country	:	US
Telephone Number	:	305-903-5636
Fax Number	:

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	06/29/2020

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