Provider Demographics
NPI:1730669128
Name:ALONZO, CAROLINA (OTA/L)
Entity type:Individual
Prefix:MRS
First Name:CAROLINA
Middle Name:
Last Name:ALONZO
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14720 SW 147TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-2355
Mailing Address - Country:US
Mailing Address - Phone:786-838-8889
Mailing Address - Fax:
Practice Address - Street 1:14720 SW 147TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-2355
Practice Address - Country:US
Practice Address - Phone:786-838-8889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14723224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant