Provider Demographics
NPI:1962703306
Name:JAIME ALVAREZ
Entity type:Organization
Organization Name:JAIME ALVAREZ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:M.D. / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:305-273-5060
Mailing Address - Street 1:9075 SW 87TH AVE STE 414
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2308
Mailing Address - Country:US
Mailing Address - Phone:305-273-5060
Mailing Address - Fax:305-274-0003
Practice Address - Street 1:9075 SW 87TH AVE STE 414
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:305-273-5060
Practice Address - Fax:305-274-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1962703306Medicaid
FL377617401Medicaid
FLME55208OtherSTATE LICENSE
FL11789ZMedicare PIN
FLME55208OtherSTATE LICENSE