Provider Demographics
NPI:1417290859
Name:ALVAREZ, DEX THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:DEX
Middle Name:THOMAS
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 S MACDILL AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-5214
Mailing Address - Country:US
Mailing Address - Phone:813-251-0246
Mailing Address - Fax:813-254-5293
Practice Address - Street 1:1502 S MACDILL AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5214
Practice Address - Country:US
Practice Address - Phone:813-251-0246
Practice Address - Fax:813-254-5293
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor