Provider Demographics
NPI:1235125659
Name:ALVAREZ, CARLOS EMILIO (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:EMILIO
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 1:3661 S MIAMI AVE
Mailing Address - Street 2:STE 1006
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4236
Mailing Address - Country:US
Mailing Address - Phone:305-854-2432
Mailing Address - Fax:305-859-9531
Practice Address - Street 1:3661 S MIAMI AVE
Practice Address - Street 2:STE 1006
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4236
Practice Address - Country:US
Practice Address - Phone:305-854-2432
Practice Address - Fax:305-859-9531
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2007-07-16
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
FL0040711208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL34048Medicare ID - Type Unspecified
FLD62276Medicare UPIN