Provider Demographics
NPI:1619155785
Name:RUBEN ALVAREZ MD, CSP
Entity Type:Organization
Organization Name:RUBEN ALVAREZ MD, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-892-1949
Mailing Address - Street 1:PO BOX 380
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683
Mailing Address - Country:US
Mailing Address - Phone:787-892-1949
Mailing Address - Fax:787-892-1949
Practice Address - Street 1:100 CALLE HERNAN ALVAREZ
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4173
Practice Address - Country:US
Practice Address - Phone:787-892-1949
Practice Address - Fax:787-892-1949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11578207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F97344Medicare UPIN