Provider Demographics
NPI:1477181576
Name:ALONSO, ANABEL (MD)
Entity type:Individual
Prefix:
First Name:ANABEL
Middle Name:
Last Name:ALONSO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14875 NW 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2565
Mailing Address - Country:US
Mailing Address - Phone:305-351-7109
Mailing Address - Fax:305-824-0665
Practice Address - Street 1:14875 NW 77TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2565
Practice Address - Country:US
Practice Address - Phone:305-351-7109
Practice Address - Fax:305-824-0665
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME163562207QG0300X, 207QH0002X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program