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NPI Code Detail

MEDICARE: MRS. WANDA ORTIZ-ALVAREZ MSW

MEDICARE: MRS. WANDA ORTIZ-ALVAREZ MSW
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
1104100000XSocial WorkerMA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104963909
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. WANDA ORTIZ-ALVAREZ MSW
Provider Business Mailing Address
First Line : 36720 ALAQUA CT
Second Line :
City : EUSTIS
State : FL
Zip : 32736-7954
Country : US
Telephone Number : 352-357-5612
Fax Number : 352-357-4674
Provider Business Practice Location Address
First Line : 1011 W INTERNATIONAL SPEEDWAY BLVD
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32114-3421
Country : US
Telephone Number : 386-258-7434
Fax Number : 386-258-2283
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 03/17/2008

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Directions to “ MRS. WANDA ORTIZ-ALVAREZ MSW” Practice Location

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