Provider Demographics
NPI:1245899442
Name:ALVAREZ SANCHEZ, YULISSA (DMD)
Entity type:Individual
Prefix:
First Name:YULISSA
Middle Name:
Last Name:ALVAREZ SANCHEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15121 SW 81ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3129
Mailing Address - Country:US
Mailing Address - Phone:786-319-3315
Mailing Address - Fax:
Practice Address - Street 1:5710 N DAVIS HWY STE 1
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2039
Practice Address - Country:US
Practice Address - Phone:850-391-3313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN24226122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist