1205286077 NPI number — SERGIO EMMANUEL ALVAREZ TORRES M.D

Table of content: SERGIO EMMANUEL ALVAREZ TORRES M.D (NPI 1205286077)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205286077 NPI number — SERGIO EMMANUEL ALVAREZ TORRES M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALVAREZ TORRES
Provider First Name:
SERGIO
Provider Middle Name:
EMMANUEL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1205286077
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE CARLOS E CHARDON URB VILLAS DE RIO CANAS
Provider Second Line Business Mailing Address:
1109
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00728
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-840-1455
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
35 CALLE MUNOZ RIVERA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ADJUNTAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00601-2202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-840-1455
Provider Business Practice Location Address Fax Number:
787-848-4657
Provider Enumeration Date:
06/13/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  22244 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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