Provider Demographics
NPI:1689170268
Name:ALVAREZ, ANA LIDICE
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:LIDICE
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6271 NW 112TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2325
Mailing Address - Country:US
Mailing Address - Phone:786-521-9590
Mailing Address - Fax:
Practice Address - Street 1:6271 NW 112TH TER
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2325
Practice Address - Country:US
Practice Address - Phone:786-521-9590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician