Provider Demographics
NPI:1255066825
Name:ALVAREZ, JOHANNA C (APRN)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:C
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 HOLLISTER AVE
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33974-4622
Mailing Address - Country:US
Mailing Address - Phone:239-994-8615
Mailing Address - Fax:
Practice Address - Street 1:910 HOLLISTER AVE
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33974-4622
Practice Address - Country:US
Practice Address - Phone:239-994-8615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020856363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily