Provider Demographics
NPI:1003637653
Name:ALVAREZ CASTILLO, ADOLFO M (LDO)
Entity type:Individual
Prefix:
First Name:ADOLFO
Middle Name:M
Last Name:ALVAREZ CASTILLO
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8651 NW 13TH TER
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1512
Mailing Address - Country:US
Mailing Address - Phone:305-470-4550
Mailing Address - Fax:305-470-4563
Practice Address - Street 1:8651 NW 13TH TER
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1512
Practice Address - Country:US
Practice Address - Phone:305-470-4550
Practice Address - Fax:305-470-4563
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO7443156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician