Healthcare Provider Details

I. General information

NPI: 1881278455
Provider Name (Legal Business Name): JACQUELINE NICOLE ALVAREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

681 4TH AVE N STE 201
NAPLES FL
34102-5729
US

IV. Provider business mailing address

681 4TH AVE N STE 201
NAPLES FL
34102-5729
US

V. Phone/Fax

Practice location:
  • Phone: 239-920-5700
  • Fax: 239-920-5710
Mailing address:
  • Phone: 239-920-5700
  • Fax: 239-920-5710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number71296
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME176313
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: