| Alonso Medical and Wellness Institute LLC | |
|
1090 W State Road 436 Altamonte Springs FL 32714-2921 | |
| (407) 869-1030 | |
| (407) 869-1025 |
| Full Name | Alonso Medical and Wellness Institute LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1090 W State Road 436, Altamonte Springs, Florida |
| Authorized Official Name and Position | Luz a Alonso (OWNER/PHYSICIAN) |
| Authorized Official Contact | 4078691030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alonso Medical and Wellness Institute LLC 1090 W State Road 436 Altamonte Springs FL 32714-2921 Ph: (407) 869-1030 | Alonso Medical and Wellness Institute LLC 1090 W State Road 436 Altamonte Springs FL 32714-2921 Ph: (407) 869-1030 |
| NPI Number | 1154712917 |
|---|---|
| Provider Enumeration Date | 02/13/2015 |
| Last Update Date | 02/17/2015 |
| Medicare PECOS PAC ID | 9638498512 |
|---|---|
| Medicare Enrollment ID | O20150427000870 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154712917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME97551 (Florida) | Primary |
| Provider Name | Kenneth Alonso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962580829 PECOS PAC ID: 1557360237 Enrollment ID: I20070201000501 |
| Provider Name | Luz a Alonso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376524223 PECOS PAC ID: 1355235045 Enrollment ID: I20070221000172 |
| Provider Name | Yorlenkys D Vega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255799037 PECOS PAC ID: 4789951716 Enrollment ID: I20170523002273 |
| Provider Name | Maday De Jesus Campo-hernandez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205566833 PECOS PAC ID: 6507221876 Enrollment ID: I20230420003123 |
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