Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 242700 | NY |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | ME 109946 | FL |
NPI | 1013159763 |
---|---|
Provider Name | Bianca Dorina Alfonso |
First Address | South Miami, FL 33143-5026 |
Second Address | South Miami, FL 33143-5026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2009 |
Last Update Date | 11/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
14J35 | BCBS (01) | FL |
352405 | AVMED (01) | FL |