Marco Antonio Alfonso, MD
Individual provider Active NPI General Practice Physician · Guayama, PR
NPI 1134811714 · NPPES record last updated May 24, 2023
Key facts
- NPI
- 1134811714
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 023233 (PR)
- Practice address
- Hospital Menonita Guayama, Av. Pedro Albizu Campos
Guayama, PR 00714 - Phone
- (787) 866-6668
- NPI assigned
- May 23, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231209000089 | PR | Practitioner - General Practice | 4183073679 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023233 | PR | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern in Hospital Medical Services LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 023233 | PR | Yes |
Addresses
Primary practice location
Hospital Menonita Guayama, Av. Pedro Albizu Campos
Guayama, PR 00714
Mailing address
Urb. Mirabella Village, Aquamarina Street
B53
Bayamon, PR 00961
Phone (939) 417-8232
Other providers in Guayama, PR
- Advanced Physical Therapy Inc
- Agape Home Care Corp
- Adriana Patricia Albino Estrada
- Ausberto Alejandro Benitez
- Carlos Armando Alejandro
- Javier J Alicea Melendez
- Carmen B Alicea
- Allmed Pharmacy LLC
- Francisco J Almenas
- Alternativa Moderna de Medicina Especializada
All providers in Guayama, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.