Provider Demographics
NPI:1821680810
Name:ANTIA ALVAREZ LLC
Entity Type:Organization
Organization Name:ANTIA ALVAREZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANTIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:786-285-0741
Mailing Address - Street 1:7574 NW 183RD TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2944
Mailing Address - Country:US
Mailing Address - Phone:786-285-0741
Mailing Address - Fax:
Practice Address - Street 1:18191 NW 68TH AVE STE 112
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3997
Practice Address - Country:US
Practice Address - Phone:786-536-6266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)