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NPI Code Detail

MEDICARE: MARYLEYDIS LOPEZ ALVAREZ

MEDICARE:   MARYLEYDIS  LOPEZ ALVAREZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-20-143403FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588266787
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYLEYDIS LOPEZ ALVAREZ
Provider Business Mailing Address
First Line : 8647 LEIGHTON DR
Second Line :
City : TAMPA
State : FL
Zip : 33614-1723
Country : US
Telephone Number : 813-510-8364
Fax Number :
Provider Business Practice Location Address
First Line : 8647 LEIGHTON DR
Second Line :
City : TAMPA
State : FL
Zip : 33614-1723
Country : US
Telephone Number : 813-510-8364
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2020
Last Update Date : 04/28/2021

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Directions to “ MARYLEYDIS LOPEZ ALVAREZ ” Practice Location

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