Healthcare Provider Details

I. General information

NPI: 1710359443
Provider Name (Legal Business Name): ALVAH FLOYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4529 E HONEYGROVE RD STE 302
VIRGINIA BEACH VA
23455-6087
US

IV. Provider business mailing address

119 SANDCASTLE CIR
SUFFOLK VA
23434-8668
US

V. Phone/Fax

Practice location:
  • Phone: 757-499-1273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020209
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: