Provider Demographics
NPI:1205873817
Name:ALVAREZ, JOSE GUILLERMO (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:GUILLERMO
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2121 SW 3RD AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129
Mailing Address - Country:US
Mailing Address - Phone:786-631-4336
Mailing Address - Fax:305-631-2806
Practice Address - Street 1:11200 WEST FLAGLER STREET
Practice Address - Street 2:SUITE 101-107
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174
Practice Address - Country:US
Practice Address - Phone:305-370-3838
Practice Address - Fax:305-220-3466
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME87964208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272249600Medicaid
I14888Medicare UPIN
FLU3111Medicare PIN