Provider Demographics
NPI:1598923229
Name:ALVAREZ, MAYALY VENEGAS (MH10727)
Entity Type:Individual
Prefix:MRS
First Name:MAYALY
Middle Name:VENEGAS
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:MH10727
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11921 S DIXIE HWY # 215
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4449
Mailing Address - Country:US
Mailing Address - Phone:786-718-3890
Mailing Address - Fax:305-238-3511
Practice Address - Street 1:11921 S DIXIE HWY STE 215
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-4449
Practice Address - Country:US
Practice Address - Phone:786-718-3890
Practice Address - Fax:305-238-3511
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10727101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health