Provider Demographics
NPI:1598069783
Name:ALVIAR RESTREPO, CARLOS LEON (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:LEON
Last Name:ALVIAR RESTREPO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:LEON
Other - Last Name:ALVIAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100277
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0277
Mailing Address - Country:US
Mailing Address - Phone:352-273-9065
Mailing Address - Fax:352-273-8889
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3001
Practice Address - Country:US
Practice Address - Phone:352-273-9065
Practice Address - Fax:352-273-8889
Is Sole Proprietor?:No
Enumeration Date:2011-01-02
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME128845207R00000X, 207RC0200X, 207RC0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018842800Medicaid
FL018842800Medicaid