Provider Demographics
NPI:1427668631
Name:ALVAREZ, RAUL A I
Entity type:Individual
Prefix:
First Name:RAUL
Middle Name:A
Last Name:ALVAREZ
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 SW 96TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2124
Mailing Address - Country:US
Mailing Address - Phone:786-369-6884
Mailing Address - Fax:
Practice Address - Street 1:526 SW 96TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2124
Practice Address - Country:US
Practice Address - Phone:786-369-6884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-130407106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician