Provider Demographics
NPI:1770759755
Name:ALVAREZ, INDIRA (AUD)
Entity type:Individual
Prefix:DR
First Name:INDIRA
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:INDIRA
Other - Middle Name:
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD
Mailing Address - Street 1:377 PALM COAST PKWY SW UNIT 3
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-4780
Mailing Address - Country:US
Mailing Address - Phone:386-283-4932
Mailing Address - Fax:863-283-4934
Practice Address - Street 1:377 PALM COAST PKWY SW UNIT 3
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-4780
Practice Address - Country:US
Practice Address - Phone:386-283-4932
Practice Address - Fax:863-283-4934
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1479231HA2400X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBN369ZOtherMEDICARE PTAN
FLBN369ZOtherMEDICARE PTAN