Provider Demographics
NPI:1003262189
Name:ALVAREZ SANCHEZ, ISMARA (PA)
Entity Type:Individual
Prefix:
First Name:ISMARA
Middle Name:
Last Name:ALVAREZ SANCHEZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12905 SW 42ND ST STE 213
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-2912
Mailing Address - Country:US
Mailing Address - Phone:786-507-8830
Mailing Address - Fax:786-294-6802
Practice Address - Street 1:12905 SW 42ND ST STE 213
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-2912
Practice Address - Country:US
Practice Address - Phone:786-507-8830
Practice Address - Fax:786-294-6802
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108312363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant