Provider Demographics
NPI:1104276583
Name:EGUSQUIZA, ALEXANDER JONAS (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:JONAS
Last Name:EGUSQUIZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 SW 97TH AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1474
Mailing Address - Country:US
Mailing Address - Phone:786-299-5419
Mailing Address - Fax:
Practice Address - Street 1:7000 SW 97TH AVE STE 120
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1474
Practice Address - Country:US
Practice Address - Phone:786-299-5419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125068984207R00000X, 208000000X
FLME161820207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics