Provider Demographics
NPI:1568528867
Name:ALVAREZ, MELVIN
Entity Type:Individual
Prefix:MR
First Name:MELVIN
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 CALLE VICENTE MUNOZ BARRIOS
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-3351
Mailing Address - Country:US
Mailing Address - Phone:787-739-7173
Mailing Address - Fax:787-739-7173
Practice Address - Street 1:29 CALLE VICENTE MUNOZ BARRIOS
Practice Address - Street 2:SUITE 101
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-3351
Practice Address - Country:US
Practice Address - Phone:787-739-7173
Practice Address - Fax:787-739-7173
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR600156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5473770001Medicare ID - Type UnspecifiedOPTICAL