Provider Demographics
NPI:1326237454
Name:ALVAREZ, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name: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 1:6240 CORAL RIDGE DR
Mailing Address - Street 2:STE 107
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3389
Mailing Address - Country:US
Mailing Address - Phone:954-753-1160
Mailing Address - Fax:
Practice Address - Street 1:6240 CORAL RIDGE DR
Practice Address - Street 2:STE 107
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3389
Practice Address - Country:US
Practice Address - Phone:954-753-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL159191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice