MEDICARE: DR. JUAN LUIS ALVAREZ DDS

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
1	122300000X	Dentist	DN 18618	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1831326974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN LUIS ALVAREZ DDS

Provider Business Mailing Address
First Line	:	11758 E DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	SEFFNER
State	:	FL
Zip	:	33584-4923
Country	:	US
Telephone Number	:	813-651-9411
Fax Number	:	813-653-0041

Provider Business Practice Location Address
First Line	:	11758 E DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	SEFFNER
State	:	FL
Zip	:	33584-4923
Country	:	US
Telephone Number	:	813-651-9411
Fax Number	:	813-653-0041

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2009
Last Update Date	:	02/24/2026

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