MEDICARE: MARIAJOSE ALVARADO RD

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	133V00000X	Registered Dietitian	ND9027	FL

General Provider Information

NPI Number	:	1215494992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAJOSE ALVARADO RD

Provider Business Mailing Address
First Line	:	2385 NW 11TH ST APT C30
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-3262
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5080 BISCAYNE BLVD STE 1-B
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33137-3218
Country	:	US
Telephone Number	:	786-422-9885
Fax Number	:

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

Provider Enumeration Date	:	02/28/2019
Last Update Date	:	02/28/2019

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Directions to “ MARIAJOSE ALVARADO RD” Practice Location

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