| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MATTHEW ALFONSO | 1588221725 | 2021-10-10 |
Matthew Alfonso is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1588221725. Registration indicates Matthew Alfonso is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) (Diagnostic Radiology (Radiology),, ) (Allopathic & Osteopathic Physicians, Radiology) (Radiology: Diagnostic Radiology, ) (Diagnostics/Imaging/Laboratory/Mammography, ) (Radiology Diagnostic Radiology, Allopathic & Osteopathic Physicians) (Radiology, )
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Dr. Matthew Alfonso MD |
| Practice Office Address | 1611 NW 12TH AVE MIAMI, FL US |
| Practice Office Telephone | 3055851111 |
| Mailing Address | 1611 NW 12TH AVE MIAMI, FL 331361096 US |
| Business Telephone | 3055851111 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 2085R0202X PRIMARY | Diagnostic Radiology (Radiology), Allopathic & Osteopathic Physicians Radiology Radiology: Diagnostic Radiology Diagnostics/Imaging/Laboratory/Mammography Radiology Diagnostic Radiology Allopathic & Osteopathic Physicians Radiology | 28747
FL |
| 193400000X SING | Group Code |