Provider Demographics
NPI:1144664079
Name:ALVARO E VISBAL MD LLC
Entity type:Organization
Organization Name:ALVARO E VISBAL MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:E
Authorized Official - Last Name:VISBAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-495-4491
Mailing Address - Street 1:120 E OAKLAND PARK BLVD
Mailing Address - Street 2:STE 105
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-1100
Mailing Address - Country:US
Mailing Address - Phone:954-495-4491
Mailing Address - Fax:954-343-9816
Practice Address - Street 1:12301 TAFT ST
Practice Address - Street 2:STE 100
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-4387
Practice Address - Country:US
Practice Address - Phone:954-495-4491
Practice Address - Fax:954-343-9816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101129207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty