Provider Demographics
NPI:1992787295
Name:WILFREDO J ALVAREZ MD PA
Entity type:Organization
Organization Name:WILFREDO J ALVAREZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILFREDO
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-270-8944
Mailing Address - Street 1:9000 SW 87TH CT
Mailing Address - Street 2:SUITE 114
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2231
Mailing Address - Country:US
Mailing Address - Phone:305-270-8944
Mailing Address - Fax:305-270-8968
Practice Address - Street 1:9000 SW 87TH CT
Practice Address - Street 2:SUITE 114
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2231
Practice Address - Country:US
Practice Address - Phone:305-270-8944
Practice Address - Fax:305-270-8968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2011-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70630207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G74863Medicare UPIN