NPIMap

Organization Active NPI

Alonso Medical and Wellness Institute LLC

  • Internal Medicine Physician
  • Altamonte Springs, FL
National Provider Identifier
1154712917
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME97551 Issued in FL
Legal business name
ALONSO MEDICAL AND WELLNESS INSTITUTE LLC
Practice address
1090 W State Road 436
Altamonte Springs, FL 32714-2921
Phone
(407) 869-1030
Fax
(407) 869-1025
NPI assigned
Feb 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Luz A Alonso, MDNPI 1376524223
Title
Owner/Physician
Phone
(407) 869-1030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME97551 FL Primary

Addresses

Primary practice location

1090 W State Road 436
Altamonte Springs, FL 32714-2921

Mailing address

1090 W State Road 436
Altamonte Springs, FL 32714-2921
Phone (407) 869-1030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150427000870 FL Part B Supplier - Clinic/Group Practice 9638498512 Receives reassigned benefits from 4 practitioners
Practice locations: Altamonte Springs, FL

National Provider Directory

National Provider Directory

Locations

1090 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 869-1030

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIIFDD

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1154712917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 W STATE ROAD 436",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142921",
            "telephone_number": "407-869-1030",
            "fax_number": "407-869-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 W STATE ROAD 436",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142921",
            "telephone_number": "407-869-1030",
            "fax_number": "407-869-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALONSO MEDICAL AND WELLNESS INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-13",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "ALONSO",
        "authorized_official_first_name": "LUZ",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "407-869-1030",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME97551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.