Provider Demographics
NPI:1093702136
Name:ALONSO, ALBERTO BRUNO (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:BRUNO
Last Name:ALONSO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 NW 42ND AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4172
Mailing Address - Country:US
Mailing Address - Phone:305-204-0333
Mailing Address - Fax:
Practice Address - Street 1:1800 N DOUGLAS RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3200
Practice Address - Country:US
Practice Address - Phone:305-204-0333
Practice Address - Fax:305-359-7546
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83960208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6931TOtherMEDICARE
FLH60678Medicare UPIN