Physician Compare National (NPI:1831400035)

HEALTHCARE PROVIDER: ADOLFO ALVINO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1831400035
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4981728730
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100831000176
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ALVINO
	Individual professional last name
Provider First Name	ADOLFO
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	LAKE JACKSON EMERGENCY PHYSICIANS LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6305108929
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	10
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3600 S HIGHLANDS AVE
	Group Practice or individual's line 1 address
City	SEBRING
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	338705416
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8633856101
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100049
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HIGHLANDS REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100252
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	RAULERSON HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	100131
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	AVENTURA HOSPITAL AND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	100189
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	NORTHWEST MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y