Healthcare Provider Details

I. General information

NPI: 1982909305
Provider Name (Legal Business Name): WILFREDO JOSE ALVAREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2011
Last Update Date: 06/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 SW 92ND ST SUITE 204
MIAMI FL
33156-7390
US

IV. Provider business mailing address

8500 SW 92ND ST SUITE 204
MIAMI FL
33156-7390
US

V. Phone/Fax

Practice location:
  • Phone: 305-270-8944
  • Fax: 305-270-8968
Mailing address:
  • Phone: 305-270-8944
  • Fax: 305-270-8968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME 70630
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: