Provider Demographics
NPI:1023012820
Name:ALVAREZ, VICTOR MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:MANUEL
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 1:2200 W EAU GALLIE BLVD
Mailing Address - Street 2:STE 202-A
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-3165
Mailing Address - Country:US
Mailing Address - Phone:321-435-0070
Mailing Address - Fax:321-435-0052
Practice Address - Street 1:2200 W EAU GALLIE BLVD
Practice Address - Street 2:STE 202-A
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-3165
Practice Address - Country:US
Practice Address - Phone:321-435-0070
Practice Address - Fax:321-435-0052
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME29415207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4038886OtherAETNA
FL6636049OtherCIGNA
FL059449100Medicaid
FL059449100Medicaid
FLD61225Medicare UPIN