Provider Demographics
NPI:1689939720
Name:ALVAREZ, HAZEL ANN RELLORES (PT)
Entity Type:Individual
Prefix:MS
First Name:HAZEL ANN
Middle Name:RELLORES
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 CATERHAM CT
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-5000
Mailing Address - Country:US
Mailing Address - Phone:443-763-1910
Mailing Address - Fax:
Practice Address - Street 1:13 CATERHAM CT
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-5000
Practice Address - Country:US
Practice Address - Phone:443-763-1910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-04
Last Update Date:2012-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD225100000X225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist