Healthcare Provider Details

I. General information

NPI: 1730600685
Provider Name (Legal Business Name): JESENIA MARIE DE JESUS ALVAREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 BLVD LUIS A FERRE
PONCE PR
00717-2112
US

IV. Provider business mailing address

97 CALLE TAYABOA
COAMO PR
00769-4926
US

V. Phone/Fax

Practice location:
  • Phone: 939-491-1328
  • Fax:
Mailing address:
  • Phone: 787-840-8686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number22325
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number22325
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: