Provider Demographics
NPI:1245694439
Name:JORGE ALVAREZ-MORENO MD
Entity type:Organization
Organization Name:JORGE ALVAREZ-MORENO MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ-MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-444-0664
Mailing Address - Street 1:5558 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2220
Mailing Address - Country:US
Mailing Address - Phone:305-444-0664
Mailing Address - Fax:305-444-0668
Practice Address - Street 1:5558 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2220
Practice Address - Country:US
Practice Address - Phone:305-444-0664
Practice Address - Fax:305-444-0668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372187600Medicaid
FL372187600Medicaid