Provider Demographics
NPI:1407953946
Name:ALVAREZ, ANGEL DAVID (BS)
Entity Type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:DAVID
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9522 SW 118TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2146
Mailing Address - Country:US
Mailing Address - Phone:305-271-5561
Mailing Address - Fax:
Practice Address - Street 1:1611 N.W. 12 AVE.
Practice Address - Street 2:OCCUPATIONAL THERAPY DEPT.
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1096
Practice Address - Country:US
Practice Address - Phone:305-585-7224
Practice Address - Fax:305-585-6007
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0002422225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist