Provider Demographics
NPI:1477637791
Name:ALVAREZ, DENNIS (OD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:DENNIS
Other - Middle Name:
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3333 W WATERS AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2758
Mailing Address - Country:US
Mailing Address - Phone:813-932-2020
Mailing Address - Fax:813-932-2001
Practice Address - Street 1:3333 W WATERS AVE
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2758
Practice Address - Country:US
Practice Address - Phone:813-932-2020
Practice Address - Fax:813-932-2001
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0000873152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19501Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER