Healthcare Provider Details
I. General information
NPI: 1811364672
Provider Name (Legal Business Name): ISRAEL D. ALVAREZ, M.D.,FAAP; ALVIS PEDIATRICS,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/27/2015
Last Update Date: 01/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18300 NW 62ND AVE SUITE 230
HIALEAH FL
33015-8200
US
IV. Provider business mailing address
18300 NW 62ND AVE SUITE 230
HIALEAH FL
33015-8200
US
V. Phone/Fax
- Phone: 305-623-4444
- Fax: 305-623-9720
- Phone: 305-623-4444
- Fax: 305-623-9720
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | ME57185 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
ISRAEL
DAVID
ALVAREZ
Title or Position: PRESIDENT
Credential: M.D
Phone: 305-623-5766