Provider Demographics
NPI:1952744856
Name:ALVAREZ, JANA R (RDH)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:R
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 OVERSEAS HWY
Mailing Address - Street 2:
Mailing Address - City:MARATHON
Mailing Address - State:FL
Mailing Address - Zip Code:33050-2239
Mailing Address - Country:US
Mailing Address - Phone:305-743-4000
Mailing Address - Fax:305-743-2873
Practice Address - Street 1:2855 OVERSEAS HWY
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-2239
Practice Address - Country:US
Practice Address - Phone:305-743-4000
Practice Address - Fax:305-743-2873
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH20237124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist