Alonso Medical And Wellness Institute Llc | |
1090 W State Road 436 Altamonte Springs FL 32714-2921 | |
(407) 869-1030 | |
(407) 869-1025 |
Full Name | Alonso Medical And Wellness Institute Llc |
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Speciality | Internal Medicine |
Location | 1090 W State Road 436, Altamonte Springs, Florida |
Authorized Official Name and Position | Luz A Alonso (OWNER/PHYSICIAN) |
Authorized Official Contact | 4078691030 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Alonso Medical And Wellness Institute Llc 1090 W State Road 436 Altamonte Springs FL 32714-2921 Ph: (407) 869-1030 | Alonso Medical And Wellness Institute Llc 1090 W State Road 436 Altamonte Springs FL 32714-2921 Ph: (407) 869-1030 |
NPI Number | 1154712917 |
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Provider Enumeration Date | 02/13/2015 |
Last Update Date | 02/17/2015 |
Medicare PECOS PAC ID | 9638498512 |
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Medicare Enrollment ID | O20150427000870 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154712917 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | ME97551 (Florida) | Primary |
Provider Name | Kenneth Alonso |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1962580829 PECOS PAC ID: 1557360237 Enrollment ID: I20070201000501 |
Provider Name | Luz A Alonso |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1376524223 PECOS PAC ID: 1355235045 Enrollment ID: I20070221000172 |
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