Provider Demographics
NPI:1497014765
Name:ALVAREZ, JOSE ALFREDO (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:ALFREDO
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 W FLAGLER ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2157
Mailing Address - Country:US
Mailing Address - Phone:786-805-3021
Mailing Address - Fax:305-847-5969
Practice Address - Street 1:8000 W FLAGLER ST STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2157
Practice Address - Country:US
Practice Address - Phone:786-805-3021
Practice Address - Fax:305-847-5969
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN196272084P0800X
FLME1211132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018098800Medicaid