Provider Demographics
NPI:1336181551
Name:ALVAREZ, SIXTO A (MD)
Entity Type:Individual
Prefix:DR
First Name:SIXTO
Middle Name:A
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HA17 CALLE ELISA TAVAREZ
Mailing Address - Street 2:7MA SECCION
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-3626
Mailing Address - Country:US
Mailing Address - Phone:787-286-6060
Mailing Address - Fax:787-286-6161
Practice Address - Street 1:24 CARR 172
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-7077
Practice Address - Country:US
Practice Address - Phone:787-286-6060
Practice Address - Fax:787-286-6161
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15079208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022241Medicare ID - Type Unspecified