Provider Demographics
NPI:1780635623
Name:ALVAREZ & ASSOCIATES MEDICAL GROUP PA
Entity Type:Organization
Organization Name:ALVAREZ & ASSOCIATES MEDICAL GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-461-1455
Mailing Address - Street 1:3940 W FLAGLER ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1613
Mailing Address - Country:US
Mailing Address - Phone:305-461-1455
Mailing Address - Fax:305-461-3682
Practice Address - Street 1:3940 W FLAGLER ST
Practice Address - Street 2:SUITE 202
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1613
Practice Address - Country:US
Practice Address - Phone:305-461-1455
Practice Address - Fax:305-461-3682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87964208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272249600Medicaid
FL272249600Medicaid
I14888Medicare UPIN
FLU3111AMedicare ID - Type UnspecifiedJOSE G ALVAREZ MD