Provider Demographics
NPI:1265765655
Name:ALVAREZ, PABLO R (DDS)
Entity type:Individual
Prefix:DR
First Name:PABLO
Middle Name:R
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9055 SW 87TH AVE
Mailing Address - Street 2:SUITE # 303
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2306
Mailing Address - Country:US
Mailing Address - Phone:305-270-5505
Mailing Address - Fax:305-270-0455
Practice Address - Street 1:9055 SW 87TH AVE
Practice Address - Street 2:SUITE # 303
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2306
Practice Address - Country:US
Practice Address - Phone:305-270-5505
Practice Address - Fax:305-270-0455
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 110241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice