Provider Demographics
NPI:1174219844
Name:ALVAREZ, NESTOR
Entity type:Individual
Prefix:
First Name:NESTOR
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22612 SW 103RD CT
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1777
Mailing Address - Country:US
Mailing Address - Phone:786-970-0370
Mailing Address - Fax:
Practice Address - Street 1:13300 SW 128TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5899
Practice Address - Country:US
Practice Address - Phone:786-250-3451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician