Healthcare Provider Details

I. General information

NPI: 1861557936
Provider Name (Legal Business Name): FREDESVINDA JACOBS-ALVAREZ MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7350 FUTURES DR SUITE 16
ORLANDO FL
32819-9083
US

IV. Provider business mailing address

7350 FUTURES DR STE 16
ORLANDO FL
32819-9084
US

V. Phone/Fax

Practice location:
  • Phone: 407-226-3733
  • Fax: 407-226-3734
Mailing address:
  • Phone: 407-226-3733
  • Fax: 407-226-3734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME79634
License Number StateFL

VIII. Authorized Official

Name: FREDESVINDA JACOBS-ALVAREZ
Title or Position: PRESIDENT/CEO
Credential:
Phone: 407-226-3733