Provider Demographics
NPI:1033653092
Name:LA ROSA ALVAREZ, FELIX
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:
Last Name:LA ROSA ALVAREZ
Suffix:
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 1:775 WARNER LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5239
Mailing Address - Country:US
Mailing Address - Phone:407-757-0785
Mailing Address - Fax:
Practice Address - Street 1:775 WARNER LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5239
Practice Address - Country:US
Practice Address - Phone:407-757-0785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-10
Last Update Date:2016-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician