Provider Demographics
NPI:1609610963
Name:ALVAREZ TORRES, JEAN MICHAEL
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:MICHAEL
Last Name:ALVAREZ TORRES
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 1:3047 CALLE HERMINIA TORMES
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-3912
Mailing Address - Country:US
Mailing Address - Phone:787-618-6580
Mailing Address - Fax:
Practice Address - Street 1:1046 AVE HOSTOS STE 118
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-1119
Practice Address - Country:US
Practice Address - Phone:787-841-3260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3051390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program