Basic Information
Provider Information
NPI: 1598797300
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALVAREZ
FirstName: OFELIA
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1601 NW 12TH AVE
Address2: BOX 016960 M851
City: MIAMI
State: FL
PostalCode: 331016960
CountryCode: US
TelephoneNumber: 3052434029
FaxNumber: 3052438470
Practice Location
Address1: 1601 NW 12TH AVE
Address2:  
City: MIAMI
State: FL
PostalCode: 331016960
CountryCode: US
TelephoneNumber: 3052434029
FaxNumber: 3052438470
Other Information
ProviderEnumerationDate: 07/06/2006
LastUpdateDate: 01/30/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0207XME68981FLY Allopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology

ID Information
IDTypeStateIssuerDescription
0065463-7005FL MEDICAID


Home