Provider Demographics
NPI:1902200538
Name:ALVAREZ LEON, MARISOL (MD)
Entity type:Individual
Prefix:
First Name:MARISOL
Middle Name:
Last Name:ALVAREZ LEON
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 1:5996 SW 70 STREET
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4816
Mailing Address - Country:US
Mailing Address - Phone:305-284-7577
Mailing Address - Fax:305-284-7688
Practice Address - Street 1:7000 SW 62ND AVE
Practice Address - Street 2:STE 600
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3314
Practice Address - Country:US
Practice Address - Phone:305-284-7577
Practice Address - Fax:305-284-7688
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-10
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR31,577390200000X
FLME148668207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program