MEDICARE: ANGELEE ALFONSO

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	APRN11047172	FL

General Provider Information

NPI Number	:	1710818653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELEE ALFONSO

Provider Business Mailing Address
First Line	:	295 W 56TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012
Country	:	US
Telephone Number	:	305-290-9066
Fax Number	:

Provider Business Practice Location Address
First Line	:	295 W 56TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012
Country	:	US
Telephone Number	:	305-290-9066
Fax Number	:

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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Directions to “ ANGELEE ALFONSO ” Practice Location

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