Provider Demographics
NPI:1629167143
Name:ALVAREZ, MAVIS (OT)
Entity Type:Individual
Prefix:
First Name:MAVIS
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MAVIS
Other - Middle Name:
Other - Last Name:ARMERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:2222 SULLIVAN TRL
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-7958
Mailing Address - Country:US
Mailing Address - Phone:610-438-2020
Mailing Address - Fax:610-438-2046
Practice Address - Street 1:1330 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2929
Practice Address - Country:US
Practice Address - Phone:305-285-1377
Practice Address - Fax:305-285-9055
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT7347225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist