1134202112 NPI number — DR. MARIA M ALONSO-PRIEGUEZ M.D.

Table of content: DR. MARIA M ALONSO-PRIEGUEZ M.D. (NPI 1134202112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134202112 NPI number — DR. MARIA M ALONSO-PRIEGUEZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALONSO-PRIEGUEZ
Provider First Name:
MARIA
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134202112
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2035 SW 21ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33145-2607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-285-1141
Provider Business Mailing Address Fax Number:
305-860-1058

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2035 SW 21ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33145-2607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-285-1141
Provider Business Practice Location Address Fax Number:
305-860-1058
Provider Enumeration Date:
10/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  ME0038911 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 120045 . This is a "PCA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 12647 . This is a "WELLCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 23243 . This is a "FOUMDATION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P075901 . This is a "PHYSICIANS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1028 . This is a "HIP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 96841 . This is a "HEALTH OPTIONS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 12647 . This is a "STAYWELL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 96841 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: D8652400 . This is a "VISTA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 005191 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0000052 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 15800 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 228658 . This is a "AMERIGROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 86401 . This is a "JACKSON" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 042483800 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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