Provider Demographics
NPI:1235687229
Name:ALVAREZ, ASHLEY HELEN (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:HELEN
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6556 WHITE BLOSSOM CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-8420
Mailing Address - Country:US
Mailing Address - Phone:904-955-7483
Mailing Address - Fax:
Practice Address - Street 1:6556 WHITE BLOSSOM CIR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-8420
Practice Address - Country:US
Practice Address - Phone:904-955-7483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL#4010390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program