Provider Demographics
NPI:1326430224
Name:ALVAREZ, ANDRES M (MD,SA C)
Entity Type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:M
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:MD,SA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 NW 74TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-4405
Mailing Address - Country:US
Mailing Address - Phone:954-446-5645
Mailing Address - Fax:
Practice Address - Street 1:1725 NW 74TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-4405
Practice Address - Country:US
Practice Address - Phone:954-446-5645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14522246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant