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General NPI Number Information
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NPI Number | 1568226447
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Entity Type | Individual
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Provider Name | ARMANDO ALVAREZ
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Gender | Male
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Dates
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Enumeration Date | 02/12/2024
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 112 GLENLIVET WAY
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City | SAINT JOHNS
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State | FL
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Zip | 32259-6941
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Country | US
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Telephone | 904-852-7383
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Fax |
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Provider Business Mailing Address
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Address Line | 112 GLENLIVET WAY
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City | SAINT JOHNS
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State | FL
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Zip | 32259-6941
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Country | US
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Telephone | 904-852-7383
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1979
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License Number State | PR
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