Provider Demographics
NPI:1760945653
Name:ALVAREZ, BIANCA ISABEL (MD)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:ISABEL
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 W MLK BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6302
Mailing Address - Country:US
Mailing Address - Phone:813-871-5437
Mailing Address - Fax:
Practice Address - Street 1:2550 W DR MLK BLVD STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6302
Practice Address - Country:US
Practice Address - Phone:813-871-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME157852208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics