Provider Demographics
NPI:1639320435
Name:MANUEL ALVAREZ-JACINTO MD PA
Entity Type:Organization
Organization Name:MANUEL ALVAREZ-JACINTO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ-JACINTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-445-3630
Mailing Address - Street 1:PO BOX 653607
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33265-3607
Mailing Address - Country:US
Mailing Address - Phone:305-445-3630
Mailing Address - Fax:305-262-7353
Practice Address - Street 1:351 NW 42ND AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5683
Practice Address - Country:US
Practice Address - Phone:305-445-3630
Practice Address - Fax:305-262-7353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty