Provider Demographics
NPI:1942841655
Name:ALVAREZ, EIDA J (RPH)
Entity Type:Individual
Prefix:MRS
First Name:EIDA
Middle Name:J
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9170 FONTAINBLEAU BLV.
Mailing Address - Street 2:UNIT 106
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172
Mailing Address - Country:US
Mailing Address - Phone:305-318-8427
Mailing Address - Fax:
Practice Address - Street 1:10332 W. FLAGER ST.
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174
Practice Address - Country:US
Practice Address - Phone:305-221-6060
Practice Address - Fax:305-221-6143
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS32036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist