Basic Information
Provider Information
NPI: 1437790953
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALVAREZ
FirstName: ANGEL
MiddleName: MICHEL
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2150 SW 26TH ST APT 8
Address2:  
City: MIAMI
State: FL
PostalCode: 331332445
CountryCode: US
TelephoneNumber: 7866552781
FaxNumber:  
Practice Location
Address1: 1611 NW 12TH AVE
Address2:  
City: MIAMI
State: FL
PostalCode: 331361096
CountryCode: US
TelephoneNumber: 3055851111
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/06/2019
LastUpdateDate: 10/06/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
204F00000XHSE29874FLY Allopathic & Osteopathic PhysiciansTransplant Surgery 

No ID Information.


Home