Healthcare Provider Details

I. General information

NPI: 1740563907
Provider Name (Legal Business Name): GADIEL RAFAEL ALVARADO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2011
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE STE 235
ORLANDO FL
32804-4659
US

IV. Provider business mailing address

2501 N ORANGE AVE STE 235
ORLANDO FL
32804-4659
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-7270
  • Fax:
Mailing address:
  • Phone: 407-303-7270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberOS19188
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number68977
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number2986
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number68977
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: