Provider Demographics
NPI:1568520633
Name:ALVAREZ, MAITE T (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MAITE
Middle Name:T
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12711 SW 66TH TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-1347
Mailing Address - Country:US
Mailing Address - Phone:305-383-3756
Mailing Address - Fax:
Practice Address - Street 1:9555 N KENDALL DR
Practice Address - Street 2:SUITE # 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1978
Practice Address - Country:US
Practice Address - Phone:305-596-5458
Practice Address - Fax:786-924-6336
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 8495235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist