Healthcare Provider Details

I. General information

NPI: 1255066825
Provider Name (Legal Business Name): JOHANNA C ALVAREZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 NICHOLAS PKWY NW STE 1
CAPE CORAL FL
33991-3804
US

IV. Provider business mailing address

290 NICHOLAS PKWY NW STE 1
CAPE CORAL FL
33991-3804
US

V. Phone/Fax

Practice location:
  • Phone: 239-573-1152
  • Fax: 239-573-1360
Mailing address:
  • Phone: 239-573-1152
  • Fax: 239-573-1360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11020856
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: