Provider Demographics
NPI:1982775367
Name:ALILIN, ELEUTERIO ROGER JR (MD)
Entity type:Individual
Prefix:DR
First Name:ELEUTERIO
Middle Name:ROGER
Last Name:ALILIN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7221 ALOMA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-7137
Mailing Address - Country:US
Mailing Address - Phone:407-657-2111
Mailing Address - Fax:866-725-4812
Practice Address - Street 1:7221 ALOMA AVE STE 200
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-7137
Practice Address - Country:US
Practice Address - Phone:407-657-2111
Practice Address - Fax:866-725-4812
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL87393207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAS339OtherGROUP PTAN
78715WMedicare PIN