Provider Demographics
NPI:1073221081
Name:M ALVAREZ, GIANINNE MARIE (MSN- AGACNP)
Entity Type:Individual
Prefix:
First Name:GIANINNE
Middle Name:MARIE
Last Name:M ALVAREZ
Suffix:
Gender:F
Credentials:MSN- AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10560 NW 51ST TER
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3210
Mailing Address - Country:US
Mailing Address - Phone:786-391-5287
Mailing Address - Fax:
Practice Address - Street 1:10560 NW 51ST TER
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-3210
Practice Address - Country:US
Practice Address - Phone:786-391-5287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022879363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty