MEDICARE: JULIO ALVARADO CAR SERVICE PROVIDER

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	172A00000X	Driver	882666775	NY

General Provider Information

NPI Number	:	1356680615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIO ALVARADO CAR SERVICE PROVIDER

Provider Business Mailing Address
First Line	:	254 E GUN HILL RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2107
Country	:	US
Telephone Number	:	718-515-2600
Fax Number	:

Provider Business Practice Location Address
First Line	:	254 E GUN HILL RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2107
Country	:	US
Telephone Number	:	718-515-2600
Fax Number	:

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

Provider Enumeration Date	:	02/06/2013
Last Update Date	:	02/06/2013

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