Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 4301106023 | MI |
Y | 207P00000X | Emergency Physician | 5315066708 | MI |
N | 207P00000X | Emergency Physician | ME131625 | FL |
NPI | 1013321280 |
---|---|
Provider Name | Corey Alvarez |
First Address | Melbourne, FL 32901-2627 |
Second Address | Melbourne, FL 32901-2627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2014 |
Last Update Date | 25/06/2020 |