Healthcare Provider Details

I. General information

NPI: 1073610333
Provider Name (Legal Business Name): NILDA J. ALVAREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 12/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB JARDINES LAFAYETTE
ARROYO PR
00714
US

IV. Provider business mailing address

PO BOX 2434
GUAYAMA PR
00785-2434
US

V. Phone/Fax

Practice location:
  • Phone: 787-839-4720
  • Fax: 787-271-0671
Mailing address:
  • Phone: 787-312-5009
  • Fax: 787-271-0671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number6278
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: