Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | ME29415 | FL |
NPI | 1023012820 |
---|---|
Provider Name | Dr. Victor Manuel Alvarez |
First Address | Melbourne, FL 32935-3165 |
Second Address | Melbourne, FL 32935-3165 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
059449100 | (05) | FL |
4038886 | AETNA (01) | FL |
6636049 | CIGNA (01) | FL |
D61225 | (02) | FL |