Provider Demographics
NPI:1578711131
Name:ALVAREZ, LORENA BEATRIZ (DPM)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:BEATRIZ
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4285 LARK VALLEY LN APT 104
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-5210
Mailing Address - Country:US
Mailing Address - Phone:216-513-7253
Mailing Address - Fax:
Practice Address - Street 1:7424 US HIGHWAY 64
Practice Address - Street 2:SUITE 119
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-3986
Practice Address - Country:US
Practice Address - Phone:901-381-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN714213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery