Provider Demographics
NPI:1376249318
Name:ALVAREZ PEREZ, VIVIAN MARGARITA
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:MARGARITA
Last Name:ALVAREZ PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10906 LANDON LN # IN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-9632
Mailing Address - Country:US
Mailing Address - Phone:813-531-2537
Mailing Address - Fax:
Practice Address - Street 1:2311 CYPRESS CV STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6784
Practice Address - Country:US
Practice Address - Phone:813-695-4051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023346363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty