Provider Demographics
NPI:1700123718
Name:ALVAREZ, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2886 ALTERNATE US 19
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683
Mailing Address - Country:US
Mailing Address - Phone:727-781-7204
Mailing Address - Fax:727-781-7175
Practice Address - Street 1:2886 ALTERNATE US 19
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683
Practice Address - Country:US
Practice Address - Phone:727-781-7204
Practice Address - Fax:727-781-7175
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist