MEDICARE: ALFONSO PRECIADO 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	208600000X	Surgery Physician	L7953	TX
2	208600000X	Surgery Physician	6656178-1205	UT
3	208600000X	Surgery Physician	ME164596	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	:	1962401315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFONSO PRECIADO MD

Provider Business Mailing Address
First Line	:	10000 W COLONIAL DR STE 393
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-3433
Country	:	US
Telephone Number	:	321-843-1378
Fax Number	:	407-296-1873

Provider Business Practice Location Address
First Line	:	10000 W COLONIAL DR STE 393
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-3433
Country	:	US
Telephone Number	:	321-843-1378
Fax Number	:	407-296-1873

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	10/17/2023

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Directions to “ ALFONSO PRECIADO MD” Practice Location

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