MEDICARE: ELIZABETH ALVAREZ CONNELLY 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	174400000X	Specialist	ME92502	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	:	1740265339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ALVAREZ CONNELLY M.D.

Provider Business Mailing Address
First Line	:	6310 SUNSET DR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-4823
Country	:	US
Telephone Number	:	305-669-2799
Fax Number	:	305-662-5895

Provider Business Practice Location Address
First Line	:	6310 SUNSET DR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-4823
Country	:	US
Telephone Number	:	305-669-2799
Fax Number	:	305-662-5895

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

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	06/06/2012

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