Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | ME 0063568 | FL |
Y | 208200000X | Surgeon | ME 0063568 | FL |
Y | 208600000X | Surgeon | ME 0063568 | FL |
NPI | 1013985357 |
---|---|
Provider Name | Dr. Jorge Alvarez-Moreno |
First Address | Coral Gables, FL 33134-2220 |
Second Address | Coral Gables, FL 33134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2006 |
Last Update Date | 15/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
372187600 | (05) | FL |
F51601 | (02) | FL |