Healthcare Provider Details

I. General information

NPI: 1558115766
Provider Name (Legal Business Name): GISSELLE ALVAREZ RCSWI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 NW 72ND AVE STE 640
MIAMI FL
33126-1921
US

IV. Provider business mailing address

25203 SW 108TH CT
HOMESTEAD FL
33032-6355
US

V. Phone/Fax

Practice location:
  • Phone: 786-497-3444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: