Provider Demographics
NPI:1659051605
Name:FAMILY MEDICAL GROUP NMB
Entity Type:Organization
Organization Name:FAMILY MEDICAL GROUP NMB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-308-9696
Mailing Address - Street 1:1011 IVES DAIRY RD STE 107
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-2536
Mailing Address - Country:US
Mailing Address - Phone:305-709-4538
Mailing Address - Fax:
Practice Address - Street 1:1011 IVES DAIRY RD STE 107
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2536
Practice Address - Country:US
Practice Address - Phone:305-705-3739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty