Basic Information
| Provider Information | |||||||||
| NPI: | 1114244803 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALVAREZ | ||||||||
| FirstName: | JUAN | ||||||||
| MiddleName: | PABLO | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4425 PONCE DE LEON BLVD STE 110 | ||||||||
| Address2: | |||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331461842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054464673 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4425 PONCE DE LEON BLVD STE 110 | ||||||||
| Address2: | |||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331461842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054464673 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2010 | ||||||||
| LastUpdateDate: | 10/29/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VE0102X | 142540 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Reproductive Endocrinology |
No ID Information.