Provider Demographics
NPI:1669995379
Name:CARDENAS ALVAREZ, JESUS (ARNP)
Entity type:Individual
Prefix:MR
First Name:JESUS
Middle Name:
Last Name:CARDENAS ALVAREZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 VANDERBILT BCH RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-8708
Mailing Address - Country:US
Mailing Address - Phone:239-624-8220
Mailing Address - Fax:239-624-8221
Practice Address - Street 1:801 VANDERBILT BCH RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-8708
Practice Address - Country:US
Practice Address - Phone:239-624-8220
Practice Address - Fax:239-624-8221
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9332570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCIVANOtherBCBS
FL023222300Medicaid
FLJE995ZOtherMEDICARE