Healthcare Provider Details

I. General information

NPI: 1215550926
Provider Name (Legal Business Name): MARCO ANTONIO ALVAREZ MORALES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2020
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 SUNSET DR
SOUTH MIAMI FL
33143-4828
US

IV. Provider business mailing address

1199 W 35TH ST APT 101
HIALEAH FL
33012-4901
US

V. Phone/Fax

Practice location:
  • Phone: 786-888-8820
  • Fax:
Mailing address:
  • Phone: 786-314-3145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberME158233
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: