Provider Demographics
NPI:1619967528
Name:ALVAREZ, WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 N MCMULLEN BOOTH RD
Mailing Address - Street 2:SUITE C3
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-2130
Mailing Address - Country:US
Mailing Address - Phone:727-723-3921
Mailing Address - Fax:727-723-1562
Practice Address - Street 1:1700 N MCMULLEN BOOTH RD
Practice Address - Street 2:SUITE C3
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-2130
Practice Address - Country:US
Practice Address - Phone:727-723-3921
Practice Address - Fax:727-723-1562
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0006142207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104093OtherAVMED
FL372051900Medicaid
FL80580OtherBCBS
FL104093OtherAVMED
FL80580BMedicare ID - Type UnspecifiedMEDICARE#