Provider Demographics
NPI:1992372775
Name:ALVAREZ, LUIS
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 W PALM DR
Mailing Address - Street 2:3ER FLOOR
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034
Mailing Address - Country:US
Mailing Address - Phone:786-379-8019
Mailing Address - Fax:
Practice Address - Street 1:713 W PALM DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-3223
Practice Address - Country:US
Practice Address - Phone:786-379-8019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-09
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care