Provider Demographics
NPI:1942849377
Name:ALVELO, FELIX ALBERTO
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:ALBERTO
Last Name:ALVELO
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:FELIX
Other - Middle Name:ALBERTO
Other - Last Name:ALVELO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:2304 JACKSON BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32304-4536
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1609 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4617
Practice Address - Country:US
Practice Address - Phone:850-431-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9112881363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant