Provider Demographics
NPI:1598815763
Name:ALVARADO, GERARDO (MD)
Entity type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:
Last Name:ALVARADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12171 SW 268TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8001
Mailing Address - Country:US
Mailing Address - Phone:305-278-0200
Mailing Address - Fax:305-851-4110
Practice Address - Street 1:818 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-5042
Practice Address - Country:US
Practice Address - Phone:561-296-4400
Practice Address - Fax:561-909-2075
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15299208D00000X
FLACN1251208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice