Provider Demographics
NPI:1578862827
Name:ALONSO, DAVID BENJAMIN (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BENJAMIN
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 1:7900 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-5405
Mailing Address - Country:US
Mailing Address - Phone:727-869-4100
Mailing Address - Fax:727-869-4197
Practice Address - Street 1:7900 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-5405
Practice Address - Country:US
Practice Address - Phone:727-869-4100
Practice Address - Fax:727-869-4197
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME114684207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine