MEDICARE: JULIO MARIO IBARS 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	363LF0000X	Family Nurse Practitioner	11014594	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1215606926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIO MARIO IBARS ALVAREZ APRN

Provider Business Mailing Address
First Line	:	14205 SW 57TH LN APT 3
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-1075
Country	:	US
Telephone Number	:	786-387-1955
Fax Number	:

Provider Business Practice Location Address
First Line	:	3181 CORAL WAY FL 5TH
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3216
Country	:	US
Telephone Number	:	305-858-3494
Fax Number	:	305-444-0780

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

Provider Enumeration Date	:	09/08/2021
Last Update Date	:	09/30/2021

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