Provider Demographics
NPI:1417240912
Name:HENRY ALVAREZ MD PA
Entity Type:Organization
Organization Name:HENRY ALVAREZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-667-1671
Mailing Address - Street 1:PO BOX 143976
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-3976
Mailing Address - Country:US
Mailing Address - Phone:305-667-1671
Mailing Address - Fax:305-444-5977
Practice Address - Street 1:7330 SW 62ND PL
Practice Address - Street 2:SUITE #400
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4825
Practice Address - Country:US
Practice Address - Phone:305-667-1671
Practice Address - Fax:305-444-5977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 44611207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL07712Medicare PIN
FLE21404Medicare UPIN