Alonzo, Leslie R

Alonzo, Leslie R is an individual health care provider with primary practice located at 403 Vonderburg Dr Ste 101, Brandon FL 33511-5982. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Alonzo, Leslie R can be contacted via phone (813) 681-1122.

Contact Information

Primary practice address
403 Vonderburg Dr Ste 101 Brandon FL 33511-5982
Fax: (813) 684-4924
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC2323 Florida

Profile Details

NPI number 1598762395
LBN Legal business name Alonzo, Leslie R
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Sep 11th, 2020 - about 6 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 1598762395 NPPES
Florida Other 4388598 AETNA
Florida Other 6500152 AETNA
Florida MEDICAID 078635700 AETNA
Florida Other 2074336 AETNA
Florida Other 19254 AETNA

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