Provider Demographics
NPI:1316104326
Name:ALVAREZ, YURI OSMEL (ARNP)
Entity type:Individual
Prefix:DR
First Name:YURI
Middle Name:OSMEL
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15830 SW 252ND ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33031-2018
Mailing Address - Country:US
Mailing Address - Phone:305-283-7956
Mailing Address - Fax:
Practice Address - Street 1:15830 SW 252ND ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33031-2018
Practice Address - Country:US
Practice Address - Phone:305-283-7956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9215108364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000187601Medicaid
FLBC896ZMedicare PIN