Provider Demographics
NPI:1851905335
Name:ALVAREZ, CHRISTAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTAN
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3731 SW 160TH AVE APT 106
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4677
Mailing Address - Country:US
Mailing Address - Phone:786-897-0447
Mailing Address - Fax:
Practice Address - Street 1:11050 GRIFFIN RD STE 104
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3227
Practice Address - Country:US
Practice Address - Phone:786-897-0447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL36263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist