Provider Demographics
NPI:1760372064
Name:ALONSO, STEPHANIE MAREE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MAREE
Last Name:ALONSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8116 PRESTIGE COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-1302
Mailing Address - Country:US
Mailing Address - Phone:954-881-5524
Mailing Address - Fax:
Practice Address - Street 1:8116 PRESTIGE COMMONS DR
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-1302
Practice Address - Country:US
Practice Address - Phone:954-881-5524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program