Provider Demographics
NPI:1962600411
Name:ALVAREZ HENRIQUEZ, GIOVANNA I (MD)
Entity type:Individual
Prefix:
First Name:GIOVANNA
Middle Name:I
Last Name:ALVAREZ HENRIQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GIOVANNA
Other - Middle Name:I
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 198054
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8054
Mailing Address - Country:US
Mailing Address - Phone:786-594-6880
Mailing Address - Fax:
Practice Address - Street 1:9555 SW 162ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-6408
Practice Address - Country:US
Practice Address - Phone:786-467-2159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432131207R00000X
HIMD-15517207R00000X, 208M00000X
FLME107610208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020008260001Medicaid
PA2089018OtherHIGHMARK BLUE SHIELD
PA1020008260003Medicaid
PA1020008260002Medicaid
PA3505786000OtherINDEPENDENCE BLUE CROSS
PAP00805682OtherRR MEDICARE
PA1020008260002Medicaid