1811918717 NPI number — VICTOR N. ALVARADO MD 'LLC'

Table of content: (NPI 1811918717)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811918717 NPI number — VICTOR N. ALVARADO MD 'LLC'

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VICTOR N. ALVARADO MD 'LLC'
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
VICTOR N. ALVARADO MD INC.
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811918717
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2160 WHISPER LAKES BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32837-6762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-438-9390
Provider Business Mailing Address Fax Number:
407-438-9389

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2160 WHISPER LAKES BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32837-6762
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-438-9390
Provider Business Practice Location Address Fax Number:
407-438-9389
Provider Enumeration Date:
07/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ALVARADO
Authorized Official First Name:
VICTOR
Authorized Official Middle Name:
N.
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
407-438-9390

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  ME 89233 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 193970 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 275680300 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1679563597 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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