1881076412 NPI number — DR. DESIREE GARCIA ALVAREZ M.D.

Table of content: DR. DESIREE GARCIA ALVAREZ M.D. (NPI 1881076412)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881076412 NPI number — DR. DESIREE GARCIA ALVAREZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA ALVAREZ
Provider First Name:
DESIREE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1881076412
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PEDIATRIX MEDICAL GROUP
Provider Second Line Business Mailing Address:
215 GRAND AVE
Provider Business Mailing Address City Name:
CORAL GABLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33133-4841
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-236-0949
Provider Business Mailing Address Fax Number:
305-448-7134

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PEDIATRIX MEDICAL GROUP
Provider Second Line Business Practice Location Address:
215 GRAND AVE
Provider Business Practice Location Address City Name:
CORAL GABLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33133-4841
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-236-0949
Provider Business Practice Location Address Fax Number:
305-448-7134
Provider Enumeration Date:
06/19/2015

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: 2080N0001X , with the licence number:  ME149911 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X , with the licence number: 0101265095 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 110574900 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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