Individual provider Active NPI

Alicia A Alonso Wolff, APRN

  • Adult Health Nurse Practitioner
  • Altamonte Springs, FL
National Provider Identifier
1760436919
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN1868672 Issued in FL
Practice address
631 Palm Springs Dr
Suite 101
Altamonte Springs, FL 32701-7854
Phone
(407) 331-1121
Fax
(407) 331-1156
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN1868672 FL
Adult Health Nurse Practitioner 363LA2200X APRN1868672 FL Primary

Addresses

Primary practice location

631 Palm Springs Dr
Suite 101
Altamonte Springs, FL 32701-7854

Mailing address

631 Palm Springs Dr
Suite 101
Altamonte Springs, FL 32701-7854
Phone (407) 331-1121

Other identifiers 1

IdentifierTypeStateIssuer
Y004KOtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070322000096 FL Practitioner - Nurse Practitioner 4082716998 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN1868672FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Nov 22, 2009 Accepting new patients
Florida Hospital Medical Group Inc Nurse Practitioner CurrentSince Nov 22, 2009 Accepting new patients

Locations

631 Palm Springs Dr
Ste 101
Altamonte Springs, FL 32701
Phone (407) 331-1121

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1760436919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 PALM SPRINGS DR",
            "address_2": "SUITE 101",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327017854",
            "telephone_number": "407-331-1121",
            "fax_number": "407-331-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 PALM SPRINGS DR",
            "address_2": "SUITE 101",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327017854",
            "telephone_number": "407-331-1121",
            "fax_number": "407-331-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "ALICIA",
        "middle_name": "A ALONSO",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN1868672",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN1868672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y004K",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.