Healthcare Provider Details

I. General information

NPI: 1962198002
Provider Name (Legal Business Name): MR. IRVINE MONTEBELLO-ALVAREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 GOODYEAR AVE
GADSDEN AL
35903-1195
US

IV. Provider business mailing address

PO BOX 680060
FRANKLIN TN
37068-0060
US

V. Phone/Fax

Practice location:
  • Phone: 256-494-4000
  • Fax: 659-235-6176
Mailing address:
  • Phone: 256-494-4000
  • Fax: 659-235-6176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-184452
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: