Healthcare Provider Details

I. General information

NPI: 1740294545
Provider Name (Legal Business Name): ALBERTO A PENALVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2780 SW 37TH AVE STE 206
COCONUT GROVE FL
33133
US

IV. Provider business mailing address

2780 SW 37TH AVE STE 206
COCONUT GROVE FL
33133-2740
US

V. Phone/Fax

Practice location:
  • Phone: 305-646-0112
  • Fax:
Mailing address:
  • Phone: 305-646-0112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number69686
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME60597
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: