Provider Demographics
NPI:1336540830
Name:ALVAREZ-MULLIN, ANGELES (MD)
Entity type:Individual
Prefix:
First Name:ANGELES
Middle Name:
Last Name:ALVAREZ-MULLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7825 BAYMEADOWS WAY SUITE 300
Mailing Address - Street 2:FLORIDA DEPT OF HEALTH, DIVISION OF DISABILITIES DETERM
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256
Mailing Address - Country:US
Mailing Address - Phone:904-390-4600
Mailing Address - Fax:904-858-3237
Practice Address - Street 1:7825 BAYMEADOWS WAY SUITE 300
Practice Address - Street 2:FLORIDA DEPT OF HEALTH, DIVISION OF DISABILITIES DETERM
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256
Practice Address - Country:US
Practice Address - Phone:904-390-4600
Practice Address - Fax:904-858-3237
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 272292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15450Medicare PIN