Healthcare Provider Details

I. General information

NPI: 1629065222
Provider Name (Legal Business Name): ANEL ALVARADO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7630 SW 34TH MNR STE 450
DAVIE FL
33328-1987
US

IV. Provider business mailing address

7630 SW 34TH MNR STE 450
DAVIE FL
33328-1987
US

V. Phone/Fax

Practice location:
  • Phone: 954-372-1429
  • Fax: 954-744-4519
Mailing address:
  • Phone: 954-372-1429
  • Fax: 954-744-4519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME79004
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: