Healthcare Provider Details
I. General information
NPI: 1710841531
Provider Name (Legal Business Name): ERIC ALVAREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8641 NW 28TH PL
SUNRISE FL
33322-2325
US
IV. Provider business mailing address
8641 NW 28TH PL
SUNRISE FL
33322-2325
US
V. Phone/Fax
- Phone: 561-358-6088
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | MA103341 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: