Provider Demographics
NPI:1083469639
Name:ALVAREZ, IVAN D
Entity type:Individual
Prefix:
First Name:IVAN
Middle Name:D
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7350 FUTURES DR STE 16
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-9084
Mailing Address - Country:US
Mailing Address - Phone:407-226-3733
Mailing Address - Fax:407-226-3734
Practice Address - Street 1:7350 FUTURES DR STE 16
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-9084
Practice Address - Country:US
Practice Address - Phone:407-226-3733
Practice Address - Fax:407-226-3734
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty