Provider Demographics
NPI:1447327697
Name:ALVARO J. DANGOND, MD,PA.
Entity type:Organization
Organization Name:ALVARO J. DANGOND, MD,PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:DANGOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-595-4478
Mailing Address - Street 1:8501 SW 124TH AVENUE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183
Mailing Address - Country:US
Mailing Address - Phone:305-595-4478
Mailing Address - Fax:305-595-5027
Practice Address - Street 1:7001 SW 97TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1410
Practice Address - Country:US
Practice Address - Phone:305-595-4478
Practice Address - Fax:305-595-5027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003117300Medicaid