Alfonso, Mayra I

Alfonso, Mayra I is an sole proprietor health care provider with primary practice located at 1902 59Th St W , Bradenton FL 34209-4602. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. Alfonso, Mayra I can be contacted via phone (941) 761-1000.

Contact Information

Primary practice address
1902 59Th St W Bradenton FL 34209-4602
Phone: (941) 761-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X ME114962 Florida

Profile Details

NPI number 1033298393
LBN Legal business name Alfonso, Mayra I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 6th, 2006
Last updated Apr 25th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033298393 NPPES
Other ME114962 FL MEDICAL LICENSE
MEDICAID Q46726 FL MEDICAL LICENSE

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