Provider Demographics
NPI:1194432955
Name:GARCIA ALVARADO, LUIS ANTONIO (NP)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:ANTONIO
Last Name:GARCIA ALVARADO
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10838 STANDING STONE DR
Mailing Address - Street 2:
Mailing Address - City:WIMAUMA
Mailing Address - State:FL
Mailing Address - Zip Code:33598-6161
Mailing Address - Country:US
Mailing Address - Phone:813-802-5932
Mailing Address - Fax:
Practice Address - Street 1:10838 STANDING STONE DR
Practice Address - Street 2:
Practice Address - City:WIMAUMA
Practice Address - State:FL
Practice Address - Zip Code:33598-6161
Practice Address - Country:US
Practice Address - Phone:813-802-5932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022797363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily