Provider Demographics
NPI:1447205018
Name:ALVAREZ GUTIERREZ, JOSE O (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:O
Last Name:ALVAREZ GUTIERREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3271
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-3271
Mailing Address - Country:US
Mailing Address - Phone:787-384-2427
Mailing Address - Fax:
Practice Address - Street 1:174 CALLE LUIS BARRERAS S
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4615
Practice Address - Country:US
Practice Address - Phone:787-384-2427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12060208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG61338Medicare UPIN