Provider Demographics
NPI:1174888739
Name:ALVAREZ, DEREK (CPHT)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13445 SW 90TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1574
Mailing Address - Country:US
Mailing Address - Phone:305-345-2695
Mailing Address - Fax:
Practice Address - Street 1:13445 SW 90TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1574
Practice Address - Country:US
Practice Address - Phone:305-345-2695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRPT8410183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician