Healthcare Provider Details

I. General information

NPI: 1902838733
Provider Name (Legal Business Name): MIGUEL A ALVAREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8340 LAKEWOOD RANCH BLVD SUITE 120
BRADENTON FL
34202-5180
US

IV. Provider business mailing address

8340 LAKEWOOD RANCH BLVD SUITE 120
BRADENTON FL
34202
US

V. Phone/Fax

Practice location:
  • Phone: 941-907-9751
  • Fax: 941-907-9554
Mailing address:
  • Phone: 941-907-9751
  • Fax: 941-907-9554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME52889
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: