Healthcare Provider Details

I. General information

NPI: 1992011951
Provider Name (Legal Business Name): LUIS A ALVAREZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2010
Last Update Date: 12/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19801 HAMPTON DR C2
BOCA RATON FL
33434-2840
US

IV. Provider business mailing address

550 S OCEAN BLVD 1604
BOCA RATON FL
33432-6264
US

V. Phone/Fax

Practice location:
  • Phone: 561-477-2862
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME98571
License Number StateFL

VIII. Authorized Official

Name: LUIS ALVAREZ
Title or Position: OWNER
Credential: MD
Phone: 561-477-2862