Provider Demographics
NPI:1538540273
Name:DIAZ, ALVARO E JR
Entity type:Individual
Prefix:
First Name:ALVARO
Middle Name:E
Last Name:DIAZ
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8520 SW 133RD AVENUE RD
Mailing Address - Street 2:314
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4510
Mailing Address - Country:US
Mailing Address - Phone:786-312-8019
Mailing Address - Fax:
Practice Address - Street 1:7392 NW 35TH TER
Practice Address - Street 2:201
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33122-1271
Practice Address - Country:US
Practice Address - Phone:305-597-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL50-427OtherAHCA TARGATED CASE MANAGEMENT