Healthcare Provider Details

I. General information

NPI: 1205092475
Provider Name (Legal Business Name): CARLOS M ALVERIO-PARES M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 06/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 HICKORY ST
MELBOURNE FL
32901
US

IV. Provider business mailing address

850 HARRISON AVE DOWLING 7 SOUTH
BOSTON MA
02118-4001
US

V. Phone/Fax

Practice location:
  • Phone: 321-434-1773
  • Fax:
Mailing address:
  • Phone: 617-638-6565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number241330
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberME120135
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number251690
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number26884-R
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME120135
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME120135
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: