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NPI Code Detail

MEDICARE: ENAK ALFONSO

MEDICARE: ENAK 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
1235Z00000XSpeech-Language PathologistSZ10870

Other Identifiers

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

General Provider Information

NPI Number : 1942926308
Entity Type Code : Individual
Provider Name (Legal Business Name) : ENAK ALFONSO
Provider Business Mailing Address
First Line : 7738 A C SKINNER PKWY APT 6305
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-8159
Country : US
Telephone Number : 321-507-7965
Fax Number :
Provider Business Practice Location Address
First Line : 8777 SAN JOSE BLVD STE 701
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32217-4292
Country : US
Telephone Number : 904-733-8255
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2022
Last Update Date : 10/18/2022

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Directions to “ ENAK ALFONSO ” 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.

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