MEDICARE: DR. NOLYRIS K ALVAREZ DMD

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	122300000X	Dentist	DN14012	FL

General Provider Information

NPI Number	:	1356371520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NOLYRIS K ALVAREZ DMD

Provider Business Mailing Address
First Line	:	3483 NE 163RD ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-4426
Country	:	US
Telephone Number	:	305-948-5002
Fax Number	:	305-948-5005

Provider Business Practice Location Address
First Line	:	3483 NE 163RD ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-4426
Country	:	US
Telephone Number	:	305-948-5002
Fax Number	:	305-948-5005

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	03/11/2009

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