Provider Demographics
NPI:1568801470
Name:ALVARADO, MAUREEN (DO)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4270 ALOMA AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-9366
Mailing Address - Country:US
Mailing Address - Phone:321-788-2777
Mailing Address - Fax:321-788-2781
Practice Address - Street 1:4270 ALOMA AVE STE 104
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9366
Practice Address - Country:US
Practice Address - Phone:321-788-2777
Practice Address - Fax:321-788-2781
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARTP 006150207Q00000X
TXQ9110207Q00000X
FLOS19293207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX361539502OtherCSHCN
TX361539501Medicaid
TX361539501Medicaid