Provider Demographics
NPI:1306082540
Name:ALVIENE, JASON ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:ROBERT
Last Name:ALVIENE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6390 BRAVA WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-8235
Mailing Address - Country:US
Mailing Address - Phone:772-828-9559
Mailing Address - Fax:
Practice Address - Street 1:1200 NW 17TH AVE STE 6
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-2512
Practice Address - Country:US
Practice Address - Phone:561-504-6344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9635111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH9635OtherLICENSE