Provider Demographics
NPI:1871983189
Name:URQUIAGA ALVAREZ, ANDRES (MD)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:
Last Name:URQUIAGA ALVAREZ
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 1:16154 SW 68TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3490
Mailing Address - Country:US
Mailing Address - Phone:786-370-1732
Mailing Address - Fax:
Practice Address - Street 1:6607 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3985
Practice Address - Country:US
Practice Address - Phone:813-499-1500
Practice Address - Fax:813-499-1499
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZC0007X
PR15605I390200000X
FLACN1389207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program