Provider Demographics
NPI:1043041726
Name:ALVAREZ, IVIS MARTINEZ (NP)
Entity type:Individual
Prefix:MRS
First Name:IVIS
Middle Name:MARTINEZ
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 SW 102ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1821
Mailing Address - Country:US
Mailing Address - Phone:305-450-6723
Mailing Address - Fax:
Practice Address - Street 1:13800 SW 56TH ST STE 121
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6061
Practice Address - Country:US
Practice Address - Phone:305-450-6723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11034515363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily