Healthcare Provider Details

I. General information

NPI: 1255426938
Provider Name (Legal Business Name): CARLOS E ALVAREZ M D P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

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 Number0009678
License Number StateFL

VIII. Authorized Official

Name: DR. CARLOS E ALVAREZ
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 305-854-2432