Healthcare Provider Details

I. General information

NPI: 1861412587
Provider Name (Legal Business Name): LUIS A ALVAREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 08/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19801 HAMPTON DR # C1-2
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: 561-477-2864
Mailing address:
  • Phone: 561-477-2862
  • Fax: 561-477-2864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME98571
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: