Provider Demographics
NPI:1598303984
Name:ALVAREZ, GILBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:GILBERTO
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GILBERTO
Other - Middle Name:
Other - Last Name:ALVAREZ INIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:13125 PAYTON ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-2757
Mailing Address - Country:US
Mailing Address - Phone:813-462-1193
Mailing Address - Fax:
Practice Address - Street 1:5265 PARK BLVD N STE 101
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3451
Practice Address - Country:US
Practice Address - Phone:727-800-5888
Practice Address - Fax:949-695-2842
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR021627208D00000X
FLACN1289208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLACN1289OtherMEDICAL LICENSE
FL118470600Medicaid