Healthcare Provider Details

I. General information

NPI: 1174366249
Provider Name (Legal Business Name): DANIEL ALVAREZ DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 06/17/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 NW 57TH ST
GAINESVILLE FL
32605
US

IV. Provider business mailing address

1210 SW 11TH AVE APT E204
GAINESVILLE FL
32601-8236
US

V. Phone/Fax

Practice location:
  • Phone: 352-332-8199
  • Fax:
Mailing address:
  • Phone: 561-460-5276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN29028
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: