Provider Demographics
NPI:1477261097
Name:ALVAREZ, GRETA (PMHNP)
Entity Type:Individual
Prefix:
First Name:GRETA
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12250 SW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3049
Mailing Address - Country:US
Mailing Address - Phone:786-314-1179
Mailing Address - Fax:
Practice Address - Street 1:8950 SW 74TH CT STE 2201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-3181
Practice Address - Country:US
Practice Address - Phone:786-637-0907
Practice Address - Fax:305-503-7338
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022721363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health