MEDICARE: ALONSO ALVAREZ 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	ME104417	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BZ392Z	OTHER	FL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952502650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALONSO ALVAREZ M.D.

Provider Business Mailing Address
First Line	:	12508 DEERBERRY LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-2336
Country	:	US
Telephone Number	:	813-855-9492
Fax Number	:

Provider Business Practice Location Address
First Line	:	5913 WEBB RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3219
Country	:	US
Telephone Number	:	813-875-8567
Fax Number	:	813-875-0188

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	09/21/2009

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Directions to “ ALONSO ALVAREZ M.D.” Practice Location

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