Provider Demographics
NPI:1144335563
Name:ALONSO, ARMANDO G (DO, PSYD)
Entity type:Individual
Prefix:DR
First Name:ARMANDO
Middle Name:G
Last Name:ALONSO
Suffix:
Gender:M
Credentials:DO, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 ATRIUM DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-3745
Mailing Address - Country:US
Mailing Address - Phone:305-301-2056
Mailing Address - Fax:
Practice Address - Street 1:3655 ATRIUM DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-3745
Practice Address - Country:US
Practice Address - Phone:305-301-2056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6977103T00000X
FLOS140062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U3461Medicare ID - Type Unspecified