Provider Demographics
NPI:1992317820
Name:ALVAREZ FERNANDEZ, HEIDY V
Entity type:Individual
Prefix:
First Name:HEIDY
Middle Name:V
Last Name:ALVAREZ FERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8817 NW 148TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-8014
Mailing Address - Country:US
Mailing Address - Phone:786-872-2835
Mailing Address - Fax:
Practice Address - Street 1:8817 NW 148TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33018-8014
Practice Address - Country:US
Practice Address - Phone:786-872-2835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-125611106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician