Provider Demographics
NPI:1528458171
Name:ALAVA, ANDRES MANUEL (ARNP)
Entity type:Individual
Prefix:MR
First Name:ANDRES
Middle Name:MANUEL
Last Name:ALAVA
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 1:9218 SW 39TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7353
Mailing Address - Country:US
Mailing Address - Phone:562-453-7331
Mailing Address - Fax:
Practice Address - Street 1:21097 NE 27TH CT
Practice Address - Street 2:SUITE 350
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1204
Practice Address - Country:US
Practice Address - Phone:305-974-5533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9311003363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily