Provider Demographics
NPI:1306944533
Name:ALVAREZ, ROSA ALICIA (DMD)
Entity type:Individual
Prefix:DR
First Name:ROSA
Middle Name:ALICIA
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3706 W 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4126
Mailing Address - Country:US
Mailing Address - Phone:305-557-6661
Mailing Address - Fax:
Practice Address - Street 1:3706 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4126
Practice Address - Country:US
Practice Address - Phone:305-557-6661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN171181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice