Provider Demographics
NPI:1104826403
Name:ALVAREZ, JORGE (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:
Last Name:ALVAREZ
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 1:8340 LAKEWOOD RANCH BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5185
Mailing Address - Country:US
Mailing Address - Phone:941-907-3008
Mailing Address - Fax:941-907-3036
Practice Address - Street 1:8340 LAKEWOOD RANCH BLVD STE 240
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5185
Practice Address - Country:US
Practice Address - Phone:941-907-3008
Practice Address - Fax:941-907-3036
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL67244207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251613600Medicaid
FL251613600Medicaid
FLG02633Medicare UPIN