Healthcare Provider Details

I. General information

NPI: 1821753781
Provider Name (Legal Business Name): MIDTOWN HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2021
Last Update Date: 11/13/2021
Certification Date: 11/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 NE 89TH ST
EL PORTAL FL
33138-3119
US

IV. Provider business mailing address

1205 SW 37TH AVE
MIAMI FL
33135-4226
US

V. Phone/Fax

Practice location:
  • Phone: 786-552-7800
  • Fax:
Mailing address:
  • Phone: 786-552-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NICOLAS R ALVAREZ
Title or Position: CEO
Credential: MD
Phone: 786-552-7800