MEDICARE: JACQUELINE R. ALVAREZ D.D.S

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	1223G0001X	General Practice Dentistry	DN 12857	FL

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	:	1639172166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE R. ALVAREZ D.D.S

Provider Business Mailing Address
First Line	:	6641 S DIXIE HWY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-7919
Country	:	US
Telephone Number	:	305-667-0306
Fax Number	:	305-667-0368

Provider Business Practice Location Address
First Line	:	6641 S DIXIE HWY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-7919
Country	:	US
Telephone Number	:	305-667-0306
Fax Number	:	305-667-0368

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

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	05/22/2008

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Directions to “ JACQUELINE R. ALVAREZ D.D.S” Practice Location

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