MEDICARE: GREGORIO ALFONSO CISNEROS MD

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	207Q00000X	Family Medicine Physician	ME84611	FL

General Provider Information

NPI Number	:	1801893854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORIO ALFONSO CISNEROS MD

Provider Business Mailing Address
First Line	:	17 OLD KINGS RD N STE J
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32137-8283
Country	:	US
Telephone Number	:	386-446-4141
Fax Number	:	386-264-6764

Provider Business Practice Location Address
First Line	:	17 OLD KINGS RD N STE J
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32137-8283
Country	:	US
Telephone Number	:	386-446-4141
Fax Number	:	386-264-6764

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

Provider Enumeration Date	:	07/06/2005
Last Update Date	:	01/09/2025

Similar Medicare Providers

1538949672 — PIVOTAL HEALTH SYSTEMS LLC
Practice Location Address:

17 OLD KINGS RD N STE E
PALM COAST, FL
32137-8283

Practice Phone: 386-283-6269
Practice Fax:

1164099552 — DR. JOSHUA WRIGHT DC
Practice Location Address:

17 OLD KINGS RD N STE E
PALM COAST, FL
32137-8283

Practice Phone: 386-283-6269
Practice Fax:

1609189968 — MR. FRANK C BENNETT PHYSICAL THERAPIST
Practice Location Address:

17 OLD KINGS RD N STE K
PALM COAST, FL
32137-8283

Practice Phone: 386-255-4596
Practice Fax: 386-258-3561

1164977534 — ORTHOPAEDIC CLINIC OF DAYTONA BEACH PA
Practice Location Address:

17 OLD KINGS RD N STE K
PALM COAST, FL
32137-8283

Practice Phone: 386-255-4596
Practice Fax: 386-258-3561

1558086629 — HEART OF CARRIE LLC
Practice Location Address:

17 OLD KINGS RD N STE E
PALM COAST, FL
32137-8283

Practice Phone: 386-585-4406
Practice Fax:

1316552714 — DR. TARA LEE LARKIN MD
Practice Location Address:

855 CINNAMON BEACH WAY
PALM COAST, FL
32137

Practice Phone: 904-465-5136
Practice Fax:

Directions to “ GREGORIO ALFONSO CISNEROS MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.