Provider Demographics
NPI:1023312147
Name:ALVAREZ, REBECA (MS-SLP)
Entity type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:MS-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18815 NW 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-2910
Mailing Address - Country:US
Mailing Address - Phone:786-534-8106
Mailing Address - Fax:786-534-8106
Practice Address - Street 1:1665 W 68TH ST STE 103
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4400
Practice Address - Country:US
Practice Address - Phone:786-534-8106
Practice Address - Fax:786-534-8107
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA12746235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist