Provider Demographics
NPI:1457464687
Name:ALVAREZ, OSVALDO (PA-C)
Entity Type:Individual
Prefix:MR
First Name:OSVALDO
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 ROBALO DR
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5240
Mailing Address - Country:US
Mailing Address - Phone:786-510-9542
Mailing Address - Fax:
Practice Address - Street 1:1945 ROBALO DR
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5240
Practice Address - Country:US
Practice Address - Phone:786-510-9542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9106195363A00000X
NC0010-00562363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S62416Medicare UPIN
S62416Medicare UPIN
NC2767619AMedicare ID - Type Unspecified