=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376601989
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GLORIA ALVAREZTORRE DMD,P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2006
-----------------------------------------------------
Last Update Date | 04/16/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11645 BISCAYNE BLVD SUITE #406
-----------------------------------------------------
City | NORTH MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33181-3155
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-892-1515
-----------------------------------------------------
Fax | 305-893-0886
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11645 BISCAYNE BLVD SUITE #406
-----------------------------------------------------
City | NORTH MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33181-3155
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-892-1515
-----------------------------------------------------
Fax | 305-893-0886
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. GLORIA ALVAREZTORRE
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 305-892-1515
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 13515
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------