Provider Demographics
NPI:1821067224
Name:ALMODOVAR, ALVIN A (MD)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:A
Last Name:ALMODOVAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALVIN
Other - Middle Name:ARIEL
Other - Last Name:ALMODOVAR - ADORNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10 CASIA STREET HOSPITAL VETERANOS - RADIOLOGIA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-641-7582
Mailing Address - Fax:
Practice Address - Street 1:10 CASIA STREET HOSPITAL VETERANOS - RADIOLOGIA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR140532085R0204X
FL899942085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology