Provider Demographics
NPI:1174202865
Name:ALVARADO, JESSICA (CERTIFIED)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:CERTIFIED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22018 SW 103RD AVE
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1149
Mailing Address - Country:US
Mailing Address - Phone:305-303-5735
Mailing Address - Fax:
Practice Address - Street 1:22018 SW 103RD AVE
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1149
Practice Address - Country:US
Practice Address - Phone:305-303-5735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
6027374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula