Healthcare Provider Details

I. General information

NPI: 1235125659
Provider Name (Legal Business Name): CARLOS EMILIO ALVAREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date: 03/23/2006
Reactivation Date: 03/28/2006

III. Provider practice location address

3661 S MIAMI AVE STE 1006
MIAMI FL
33133-4236
US

IV. Provider business mailing address

3661 S MIAMI AVE STE 1006
MIAMI FL
33133-4236
US

V. Phone/Fax

Practice location:
  • Phone: 305-854-2432
  • Fax: 305-859-9531
Mailing address:
  • Phone: 305-854-2432
  • Fax: 305-859-9531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number0040711
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: