Individual provider Active NPI

Leonardo Lazaro Alonso, D.O.

  • Emergency Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1518062249
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS-6584 Issued in FL
Practice address
8761 Perimeter Park Blvd Ste 106
Jacksonville, FL 32216-6397
Phone
(904) 641-6628
NPI assigned
Sep 14, 2006
Last updated
Sep 18, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS-6584 FL Primary
Emergency Medicine Physician 207P00000X 3206 WV

Addresses

Primary practice location

8761 Perimeter Park Blvd Ste 106
Jacksonville, FL 32216-6397

Mailing address

831 Chicopit LN
Jacksonville, FL 32225-4913
Phone (904) 221-8961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, WV3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20100813000901 FL Practitioner - Emergency Medicine 7618001520 Reassigns benefits to 1 organization
I20151014003177 GA Practitioner - Emergency Medicine 7618001520 Reassigns benefits to 1 organization
I20171019002219 WV Practitioner - Emergency Medicine 7618001520 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS-6584FLMDEmergency Medicine Physician
3206WVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. Current Accepting new patients
Cep America, LLC Emergency Medicine CurrentSince Jun 21, 2023 Accepting new patients
South Georgia Emergency Medicine Associates PC Emergency Medicine CurrentSince Mar 15, 2022 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Sep 18, 2017 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jun 21, 2023 Accepting new patients
Florida Em-I Medical Services, PA Emergency Medicine Past Accepting new patients
Florida Em-I Medical Services, PA Emergency Medicine Past Accepting new patients
Florida Em-I Medical Services PA Emergency Medicine Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

8083 Parramore Rd
Jacksonville, FL 32244
Phone (904) 450-6760

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

615 N Bonita Ave
Panama City, FL 32401
Phone (850) 747-2020

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

Interoperability endpoints

  • Direct secure messaging: lalonso180186@direct.phs.org
  • Direct secure messaging: leo.alonso.1@14441.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505692800000",
    "number": "1518062249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 CHICOPIT LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322254913",
            "telephone_number": "904-221-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8761 PERIMETER PARK BLVD STE 106",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166397",
            "telephone_number": "904-641-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALONSO",
        "first_name": "LEONARDO",
        "middle_name": "LAZARO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2017-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS-6584",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "3206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.