=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073970513
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JASON F. ALVAREZ, D.C., P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2016
-----------------------------------------------------
Last Update Date | 03/31/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9560 SW 107TH AVE STE 105
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33176-2790
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-505-3449
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9560 SW 107TH AVE STE 105
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33176-2790
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-505-3449
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PST
-----------------------------------------------------
Name | JASON FELIX ALVAREZ
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 305-505-3449
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH9593
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------