Provider Demographics
NPI:1770598641
Name:ALZUGARAY, SERGIO F (MD)
Entity type:Individual
Prefix:
First Name:SERGIO
Middle Name:F
Last Name:ALZUGARAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7750 NW 171ST ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3840
Mailing Address - Country:US
Mailing Address - Phone:786-768-3324
Mailing Address - Fax:
Practice Address - Street 1:12540 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1412
Practice Address - Country:US
Practice Address - Phone:305-705-6840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73697208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME73697OtherDEPARTMENT OF HEALTH
FL253617000Medicaid