MEDICARE: DR. LUIS RAFAEL ALVARADO LOPEZ M.D.

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	207Q00000X	Family Medicine Physician	ACN794	FL
2	207Q00000X	Family Medicine Physician	12274	PR
3	208D00000X	General Practice Physician	ACN794	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	IR541Z	OTHER	FL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	ACN794	OTHER	FL	MEDICAL LICENSE

General Provider Information

NPI Number	:	1467424143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS RAFAEL ALVARADO LOPEZ M.D.

Provider Business Mailing Address
First Line	:	425 W COLONIAL DR STE 303
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6863
Country	:	US
Telephone Number	:	407-986-9642
Fax Number	:	689-304-0303

Provider Business Practice Location Address
First Line	:	1931 S NARCOOSSEE RD
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-7211
Country	:	US
Telephone Number	:	407-986-9642
Fax Number	:	833-450-5421

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

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	08/12/2025

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Directions to “ DR. LUIS RAFAEL ALVARADO LOPEZ M.D.” Practice Location

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