MEDICARE: MRS. GLADYVI ALVARADO M.A.

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1306245022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GLADYVI ALVARADO M.A.

Provider Business Mailing Address
First Line	:	2373 N CENTRAL AVE APT C-132
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-2306
Country	:	US
Telephone Number	:	787-410-9380
Fax Number	:

Provider Business Practice Location Address
First Line	:	2373 N CENTRAL AVE APT C-132
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-2306
Country	:	US
Telephone Number	:	787-410-9380
Fax Number	:

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

Provider Enumeration Date	:	08/19/2014
Last Update Date	:	08/19/2014

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