Healthcare Provider Details

I. General information

NPI: 1609839612
Provider Name (Legal Business Name): HERNANDO ALVAREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 08/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 W 20TH AVE SUITE 803
HIALEAH FL
33016-1897
US

IV. Provider business mailing address

7100 W 20TH AVE SUITE 304
HIALEAH FL
33016-1897
US

V. Phone/Fax

Practice location:
  • Phone: 305-556-3122
  • Fax: 305-828-7860
Mailing address:
  • Phone: 305-556-3122
  • Fax: 305-828-7860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME48939
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: