Provider Demographics
NPI:1699267344
Name:ALVAREZ VELAZQUEZ, IRIS (APRN)
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:ALVAREZ VELAZQUEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3428 ROGERO RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-2554
Mailing Address - Country:US
Mailing Address - Phone:786-366-9873
Mailing Address - Fax:
Practice Address - Street 1:10240 FULCRUM AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-8178
Practice Address - Country:US
Practice Address - Phone:786-366-9873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9478194163W00000X
FL11022796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse