Provider Demographics
NPI:1417945619
Name:ALVAREZ, PEDRO GABRIEL (DO)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:GABRIEL
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 W 20TH AVE STE 607
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5534
Mailing Address - Country:US
Mailing Address - Phone:305-558-8600
Mailing Address - Fax:305-822-1986
Practice Address - Street 1:7150 W 20TH AVE STE 607
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5534
Practice Address - Country:US
Practice Address - Phone:305-558-8600
Practice Address - Fax:305-822-1986
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7248207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL44359Medicare ID - Type Unspecified
G91063Medicare UPIN