Provider Demographics
NPI:1619651122
Name:GARCIA ALVAREZ, DENIS WILLIAN
Entity Type:Individual
Prefix:
First Name:DENIS
Middle Name:WILLIAN
Last Name:GARCIA ALVAREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11700 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3497
Mailing Address - Country:US
Mailing Address - Phone:786-365-0928
Mailing Address - Fax:
Practice Address - Street 1:11700 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-3497
Practice Address - Country:US
Practice Address - Phone:786-365-0928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician