Provider Demographics
NPI:1609839612
Name:ALVAREZ, HERNANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:HERNANDO
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 W 20TH AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1897
Mailing Address - Country:US
Mailing Address - Phone:305-556-3122
Mailing Address - Fax:305-828-7860
Practice Address - Street 1:7100 W 20TH AVE
Practice Address - Street 2:SUITE 803
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1897
Practice Address - Country:US
Practice Address - Phone:305-556-3122
Practice Address - Fax:305-828-7860
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME48939207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL044653000Medicaid
FL044653000Medicaid