Provider Demographics
NPI:1528366622
Name:ERIK X ALONSO PSY D LCSW PA
Entity type:Organization
Organization Name:ERIK X ALONSO PSY D LCSW PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYD, LCSW
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:X
Authorized Official - Last Name:ALONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-321-5279
Mailing Address - Street 1:22056 SW 131ST PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-2659
Mailing Address - Country:US
Mailing Address - Phone:305-774-1007
Mailing Address - Fax:305-774-1009
Practice Address - Street 1:350 SEVILLA AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6617
Practice Address - Country:US
Practice Address - Phone:305-774-1007
Practice Address - Fax:305-774-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty