Healthcare Provider Details

I. General information

NPI: 1720313844
Provider Name (Legal Business Name): FERNANDO ALVAREZ PEREZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2009
Last Update Date: 10/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3661 S MIAMI AVE SUITE 106
MIAMI FL
33133-4236
US

IV. Provider business mailing address

3661 S MIAMI AVE SUITE 106
MIAMI FL
33133-4236
US

V. Phone/Fax

Practice location:
  • Phone: 305-854-9966
  • Fax: 305-856-0052
Mailing address:
  • Phone: 305-854-9966
  • Fax: 305-856-0052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberME 0046653
License Number StateFL

VIII. Authorized Official

Name: DR. FERNANDO JULIO ALVAREZ PEREZ
Title or Position: PHYSICIAN/ OB GYN
Credential: MD
Phone: 305-854-9966