Provider Demographics
NPI:1487316691
Name:ALONSO, LUIS M (HAS)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:M
Last Name:ALONSO
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6532 SW 148TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-2019
Mailing Address - Country:US
Mailing Address - Phone:305-498-4090
Mailing Address - Fax:
Practice Address - Street 1:10701 SW 38TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3618
Practice Address - Country:US
Practice Address - Phone:305-225-5471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
237700000X
FL4830237700000X
FL5594237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist