Healthcare Provider Details

I. General information

NPI: 1104626761
Provider Name (Legal Business Name): JORGE ANTONIO ALVAREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JORGE ANTONIO ALVAREZ MD

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 NE 167TH ST
MIAMI FL
33162-2304
US

IV. Provider business mailing address

1300 W 47TH PL APT 206
HIALEAH FL
33012-3277
US

V. Phone/Fax

Practice location:
  • Phone: 305-949-2000
  • Fax: 786-623-5343
Mailing address:
  • Phone: 786-865-0171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberHSE41491
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: