Healthcare Provider Details

I. General information

NPI: 1922593375
Provider Name (Legal Business Name): RAYSA ENITH LOPEZ ALVARADO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9555 SW 162ND AVE
MIAMI FL
33196-6408
US

IV. Provider business mailing address

PO BOX 853
NARANJITO PR
00719-0853
US

V. Phone/Fax

Practice location:
  • Phone: 786-467-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME182645
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: