Provider Demographics
NPI:1174553739
Name:ALONSO, JOSEPH R (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:ALONSO
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 1:3310 SW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7422
Mailing Address - Country:US
Mailing Address - Phone:352-861-9811
Mailing Address - Fax:352-873-3254
Practice Address - Street 1:3310 SW 34TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7422
Practice Address - Country:US
Practice Address - Phone:352-861-9811
Practice Address - Fax:352-873-3254
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75635207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253972100Medicaid
FL43342XMedicare PIN
FL253972100Medicaid