Provider Demographics
NPI:1487378253
Name:ALVARADO, ANGELIS (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELIS
Middle Name:
Last Name:ALVARADO
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 1:2201 CARR 14 APT 11302
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2318
Mailing Address - Country:US
Mailing Address - Phone:787-240-5516
Mailing Address - Fax:
Practice Address - Street 1:2201 CARR 14 APT 11302
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2318
Practice Address - Country:US
Practice Address - Phone:787-240-5516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR023016208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice