Healthcare Provider Details
I. General information
NPI: 1811912660
Provider Name (Legal Business Name): ALVAREZ & GARCIA, PA.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/13/2006
Last Update Date: 05/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6641-A SOUTH DIXIE HIGHWAY
MIAMI FL
33143-7919
US
IV. Provider business mailing address
6641-A SOUTH DIXIE HIGHWAY
MIAMI FL
33143-7919
US
V. Phone/Fax
- Phone: 305-667-0306
- Fax: 305-667-0368
- Phone: 305-667-0306
- Fax: 305-667-0368
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | DN12696 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
MARIO
KENNETH
GARCIA
Title or Position: PRESIDENT/DENTIST
Credential: D.D.S
Phone: 305-667-0306