Healthcare Provider Details

I. General information

NPI: 1689618647
Provider Name (Legal Business Name): MANUEL E ALVAREZ PHD PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 10/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 N KENDALL DR SUITE 415
MIAMI FL
33156-7564
US

IV. Provider business mailing address

7700 N KENDALL DR SUITE 415
MIAMI FL
33156-7564
US

V. Phone/Fax

Practice location:
  • Phone: 305-274-2403
  • Fax: 305-274-2433
Mailing address:
  • Phone: 305-274-2403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPY3272
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: