Provider Demographics
NPI:1629065222
Name:ALVARADO, ANEL (MD)
Entity Type:Individual
Prefix:
First Name:ANEL
Middle Name:
Last Name:ALVARADO
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 1:7630 SW 34TH MNR STE 450
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-1987
Mailing Address - Country:US
Mailing Address - Phone:954-372-1429
Mailing Address - Fax:954-744-4519
Practice Address - Street 1:7630 SW 34TH MNR STE 450
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-1987
Practice Address - Country:US
Practice Address - Phone:954-372-1429
Practice Address - Fax:954-744-4519
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79004208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL201224718OtherTAX IDENTIFICATION
FL257554000Medicaid
FL201224718OtherTAX IDENTIFICATION
FL257554000Medicaid