Healthcare Provider Details

I. General information

NPI: 1134129760
Provider Name (Legal Business Name): SONIA M ALVAREZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: SONIA M ALVAREZ-ESCUDERO M.D.

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 HOUMA BLVD SUITE 108
METAIRIE LA
70006-2932
US

IV. Provider business mailing address

5902 ANNUNCIATION ST
NEW ORLEANS LA
70115-2158
US

V. Phone/Fax

Practice location:
  • Phone: 504-455-2771
  • Fax: 504-885-0441
Mailing address:
  • Phone: 504-899-9633
  • Fax: 504-885-0441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13869R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: