Healthcare Provider Details

I. General information

NPI: 1962032425
Provider Name (Legal Business Name): DAYAN ALVAREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 GLADES RD STE 400
BOCA RATON FL
33431-6464
US

IV. Provider business mailing address

15228 SW 22ND TER
MIAMI FL
33185-5703
US

V. Phone/Fax

Practice location:
  • Phone: 561-955-2570
  • Fax:
Mailing address:
  • Phone: 305-927-2856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME167425
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-110653
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: