Provider Demographics
NPI:1477850329
Name:MARCY ALVAREZ, DO. PA
Entity Type:Organization
Organization Name:MARCY ALVAREZ, DO. PA
Other - Org Name:LINCOLN ROAD DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:306-397-8622
Mailing Address - Street 1:1111 LINCOLN RD
Mailing Address - Street 2:SUITE 375
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-2452
Mailing Address - Country:US
Mailing Address - Phone:305-397-8622
Mailing Address - Fax:305-397-8422
Practice Address - Street 1:1111 LINCOLN RD
Practice Address - Street 2:SUITE 375
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-2452
Practice Address - Country:US
Practice Address - Phone:305-397-8622
Practice Address - Fax:305-397-8422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10899207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty