Provider Demographics
NPI:1689555153
Name:ALVAREZ NEGRIN, ANGELO S
Entity type:Individual
Prefix:
First Name:ANGELO
Middle Name:S
Last Name:ALVAREZ NEGRIN
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 1:14921 SW 80TH ST APT 212
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3153
Mailing Address - Country:US
Mailing Address - Phone:409-949-4473
Mailing Address - Fax:
Practice Address - Street 1:14921 SW 80TH ST APT 212
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-3153
Practice Address - Country:US
Practice Address - Phone:409-949-4473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-49248106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty