Provider Demographics
NPI:1811652068
Name:MOTHER STEM INSTITUTE INC
Entity type:Organization
Organization Name:MOTHER STEM INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-443-4126
Mailing Address - Street 1:2100 PONCE DE LEON BLVD STE 1010
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5240
Mailing Address - Country:US
Mailing Address - Phone:305-443-4126
Mailing Address - Fax:305-444-7509
Practice Address - Street 1:2100 PONCE DE LEON BLVD STE 1010
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5240
Practice Address - Country:US
Practice Address - Phone:305-443-4126
Practice Address - Fax:305-444-7509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty