Healthcare Provider Details

I. General information

NPI: 1184156705
Provider Name (Legal Business Name): LEONOR ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2017
Last Update Date: 04/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5180 W ATLANTIC AVE SUITE 114
DELRAY BEACH FL
33484-8103
US

IV. Provider business mailing address

2430 DEER CREEK COUNTRY CLUB BLVD T2-601
DEERFIELD BEACH FL
33442-1102
US

V. Phone/Fax

Practice location:
  • Phone: 561-674-9996
  • Fax:
Mailing address:
  • Phone: 954-598-5842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: