Provider Demographics
NPI:1093315491
Name:CHIPI ALVAREZ, JULIO JAVIER
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:JAVIER
Last Name:CHIPI 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 1:3816 NW 201ST TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-1427
Mailing Address - Country:US
Mailing Address - Phone:786-539-9823
Mailing Address - Fax:
Practice Address - Street 1:3816 NW 201ST TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-1427
Practice Address - Country:US
Practice Address - Phone:786-539-9823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLRBT-20-120092106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician