Provider Demographics
NPI:1073360483
Name:ALVARO, CARA (MBA)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:ALVARO
Suffix:
Gender:
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-9221
Mailing Address - Country:US
Mailing Address - Phone:505-793-5175
Mailing Address - Fax:
Practice Address - Street 1:4266 US 64
Practice Address - Street 2:
Practice Address - City:KIRTLAND
Practice Address - State:NM
Practice Address - Zip Code:87417-9420
Practice Address - Country:US
Practice Address - Phone:505-793-5175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies