Individual provider Active NPI

Noel Alonso, M.D.

  • Pediatrics Physician
  • Davie, FL
National Provider Identifier
1902985344
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME 83532 Issued in FL
Practice address
3200 S University Dr
Davie, FL 33328-2018
Phone
(305) 336-0108
Fax
(954) 262-1888
NPI assigned
Nov 5, 2006
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME 83532 FL Primary

Addresses

Primary practice location

3200 S University Dr
Davie, FL 33328-2018

Mailing address

1301 SW 69TH Ave
Plantation, FL 33317-5058
Phone (305) 336-0108

Other identifiers 1

IdentifierTypeStateIssuer
265403200MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://login.intelichart.com/NSUHealthClinics/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160201001199 FL Practitioner - Pediatric Medicine 0042514762 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 83532FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc CurrentSince Jan 1, 2017 Accepting new patients
Phoenix Emergency Medicine of Broward LLC CurrentSince Nov 4, 2015 Accepting new patients
Nova Southeastern University, Inc Current Accepting new patients
Nova Southeastern University Inc. CurrentSince Jan 1, 2017 Accepting new patients
Phoenix Emergency Medicine of Broward LLC Current Accepting new patients
Nova Southeastern University, Inc Pediatrics Past Accepting new patients
After Hours Pediatrics, Inc. Past Accepting new patients

Locations

3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250

3200 S University Dr
#L
Davie, FL 33328
Phone (954) 262-4149

201 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 786-6400

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000

5565 Centerview Dr
Ste 107
Raleigh, NC 27606
Phone (213) 484-7111

Organizations & group practices 7

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": "1162684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1902985344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SW 69TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333175058",
            "telephone_number": "305-336-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "305-336-0108",
            "fax_number": "954-262-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALONSO",
        "first_name": "NOEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-05",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 83532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265403200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://login.intelichart.com/NSUHealthClinics/",
            "affiliation": "N",
            "address_1": "3200 S University Dr",
            "city": "Davie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333282018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.