Provider Demographics
NPI:1629378559
Name:ALVAREZ, NIMIA R (DDS)
Entity Type:Individual
Prefix:
First Name:NIMIA
Middle Name:R
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 NE 8TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4607
Mailing Address - Country:US
Mailing Address - Phone:305-245-0304
Mailing Address - Fax:305-245-0306
Practice Address - Street 1:127 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4607
Practice Address - Country:US
Practice Address - Phone:305-245-0304
Practice Address - Fax:305-245-0306
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00121881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice