Provider Demographics
NPI:1619609716
Name:ALVAREZ, DALILA VICTORIA (BA,CBHCM)
Entity Type:Individual
Prefix:
First Name:DALILA
Middle Name:VICTORIA
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:BA,CBHCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6403 SW 152ND PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-2141
Mailing Address - Country:US
Mailing Address - Phone:786-509-0441
Mailing Address - Fax:
Practice Address - Street 1:6403 SW 152ND PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-2141
Practice Address - Country:US
Practice Address - Phone:786-509-0441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCM104574171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCBHCM104574OtherFLORIDA CERTIFICATION BOARD