Provider Demographics
NPI:1508870833
Name:JORGE E. ALVAREZ, MD, PA
Entity Type:Organization
Organization Name:JORGE E. ALVAREZ, MD, PA
Other - Org Name:OBGYN WOMENS CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GRISEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-907-3008
Mailing Address - Street 1:8374 MARKET ST
Mailing Address - Street 2:#492
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5137
Mailing Address - Country:US
Mailing Address - Phone:941-907-3008
Mailing Address - Fax:941-907-3036
Practice Address - Street 1:8340 LAKEWOOD RANCH BLVD
Practice Address - Street 2:STE 240
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-5180
Practice Address - Country:US
Practice Address - Phone:941-907-3008
Practice Address - Fax:940-907-3036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3483Medicare ID - Type UnspecifiedMEDICARE GRP #