Provider Demographics
NPI:1972869584
Name:ALVAREZ, SARAH MIKE (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MIKE
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3606 MACLAY BLVD S STE 102
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-1277
Mailing Address - Country:US
Mailing Address - Phone:850-877-1162
Mailing Address - Fax:850-671-5009
Practice Address - Street 1:3606 MACLAY BLVD S STE 102
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-1277
Practice Address - Country:US
Practice Address - Phone:850-877-1162
Practice Address - Fax:850-671-5009
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS25175208000000X
LAMD.208084208000000X
FL136056208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100687700Medicaid