Provider Demographics
NPI:1588249361
Name:PEREZ ALVAREZ, MADIOLYS (DMD)
Entity type:Individual
Prefix:
First Name:MADIOLYS
Middle Name:
Last Name:PEREZ ALVAREZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18482 NW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3440
Mailing Address - Country:US
Mailing Address - Phone:305-590-5779
Mailing Address - Fax:
Practice Address - Street 1:18482 NW 67TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3440
Practice Address - Country:US
Practice Address - Phone:305-590-5779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28134122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist