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General NPI Number Information
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NPI Number | 1144664079
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Entity Type | Organization
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Legal Business Name | ALVARO E VISBAL MD LLC
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 05/28/2013
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Provider Practice Location Address
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Address Line | 12301 TAFT ST STE 100
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-4387
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Country | US
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Telephone | 954-495-4491
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Fax | 954-343-9816
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Provider Business Mailing Address
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Address Line | 120 E OAKLAND PARK BLVD STE 105
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City | OAKLAND PARK
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State | FL
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Zip | 33334-1100
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Country | US
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Telephone | 954-495-4491
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Fax | 954-343-9816
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Authorized Official
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Title or Position | MGR
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Name | ALVARO E VISBAL
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Credential | MD
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Telephone | 954-495-4491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | ME101129
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME101129
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License Number State | FL
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