Provider Demographics
NPI:1356386973
Name:MANOTAS, ALVARO G (MD)
Entity type:Individual
Prefix:DR
First Name:ALVARO
Middle Name:G
Last Name:MANOTAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:817 S UNIVERSITY DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3309
Mailing Address - Country:US
Mailing Address - Phone:954-474-9777
Mailing Address - Fax:954-474-9744
Practice Address - Street 1:817 S UNIVERSITY DR
Practice Address - Street 2:SUITE 120
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3309
Practice Address - Country:US
Practice Address - Phone:954-474-9777
Practice Address - Fax:954-474-9744
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME00407742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD78857Medicare UPIN
FL94159Medicare ID - Type Unspecified