Individual provider Active NPI

Teresita Alonzo

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Milton, FL
National Provider Identifier
1306279666
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
6905409 Issued in FL
Practice address
6632 Trailride N
Milton, FL 32570-3278
Phone
(850) 626-4897
NPI assigned
Aug 9, 2013
Last updated
Aug 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 6905409 FL Primary

Addresses

Primary practice location

6632 Trailride N
Milton, FL 32570-3278

Mailing address

6632 Trailride N
Milton, FL 32570-3278
Phone (850) 626-4897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6905409FLMDIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

NPI Registry JSON

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1306279666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6632 TRAILRIDE N",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325703278",
            "telephone_number": "850-626-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6632 TRAILRIDE N",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325703278",
            "telephone_number": "850-626-4897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALONZO",
        "first_name": "TERESITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "6905409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.