MEDICARE: MR. OSVALDO ALVAREZ PA-C

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	363A00000X	Physician Assistant	PA9106195	FL
2	363A00000X	Physician Assistant	0010-00562	NC

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	:	1457464687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. OSVALDO ALVAREZ PA-C

Provider Business Mailing Address
First Line	:	1945 ROBALO DR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5240
Country	:	US
Telephone Number	:	786-510-9542
Fax Number	:

Provider Business Practice Location Address
First Line	:	1945 ROBALO DR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5240
Country	:	US
Telephone Number	:	786-510-9542
Fax Number	:

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

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	07/06/2018

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