Healthcare Provider Details

I. General information

NPI: 1952969834
Provider Name (Legal Business Name): JOSE ALBERTO ALVARADO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AUTOPISTA LUIS A FERRE SALIDA 21 CARR. 172 URB. TURABO GARDENS
CAGUAS PR
00726
US

IV. Provider business mailing address

503 CALLE EXTENSION S
DORADO PR
00646-5016
US

V. Phone/Fax

Practice location:
  • Phone: 787-743-3038
  • Fax:
Mailing address:
  • Phone: 787-796-1049
  • Fax: 787-746-3093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number24707
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number24707
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: