Basic Information
| Provider Information | |||||||||
| NPI: | 1295129484 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALVAREZ CASTELLARES | ||||||||
| FirstName: | VANESSA | ||||||||
| MiddleName: | URSULA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ALVAREZ | ||||||||
| OtherFirstName: | VANESSA | ||||||||
| OtherMiddleName: | URSULA | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 13707 SW 152ND ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331771106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055859200 | ||||||||
| FaxNumber: | 3053552900 | ||||||||
| Practice Location | |||||||||
| Address1: | 13707 SW 152ND ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331771106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055859200 | ||||||||
| FaxNumber: | 3053552900 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2015 | ||||||||
| LastUpdateDate: | 10/25/2019 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| ParentOrganizationLBN: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ME140578 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A137742 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.