Healthcare Provider Details

I. General information

NPI: 1699691709
Provider Name (Legal Business Name): JOSE MADRIGAL ALVAREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4345 18TH ST NE
NAPLES FL
34120-6415
US

IV. Provider business mailing address

4345 18TH ST NE
NAPLES FL
34120-6415
US

V. Phone/Fax

Practice location:
  • Phone: 239-898-9157
  • Fax:
Mailing address:
  • Phone: 239-898-9157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-488784
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: