Healthcare Provider Details

I. General information

NPI: 1861308793
Provider Name (Legal Business Name): SEBASTIAN AARON ALVAREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 W OKLAHOMA AVE STE 2
GRAND ISLAND NE
68801-6781
US

IV. Provider business mailing address

1011 S PINE ST
GRAND ISLAND NE
68801-7946
US

V. Phone/Fax

Practice location:
  • Phone: 308-381-1690
  • Fax:
Mailing address:
  • Phone: 210-861-4038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: