MEDICARE: FABIOLA DENISE ALVAREZ APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	APRN11045182	FL

General Provider Information

NPI Number	:	1093666117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FABIOLA DENISE ALVAREZ APRN

Provider Business Mailing Address
First Line	:	5422 BEVERLY RISE BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33812-5102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6595 S FLORIDA AVE
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-3316
Country	:	US
Telephone Number	:	863-593-7804
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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