Healthcare Provider Details

I. General information

NPI: 1992451108
Provider Name (Legal Business Name): MELISSA JOAN ALVAREZ RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2022
Last Update Date: 02/25/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 N JEFFERSON ST RM 2J101
JACKSONVILLE FL
32209-6525
US

IV. Provider business mailing address

2105 RIVER BLVD APT 3
JACKSONVILLE FL
32204-4469
US

V. Phone/Fax

Practice location:
  • Phone: 904-475-5889
  • Fax:
Mailing address:
  • Phone: 402-939-9777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRT17767
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: