Basic Information
| Provider Information | |||||||||
| NPI: | 1639107212 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIRVEN | ||||||||
| FirstName: | ALBERTO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8200 SW 117TH AVE | ||||||||
| Address2: | 304 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331834824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052265651 | ||||||||
| FaxNumber: | 3052262424 | ||||||||
| Practice Location | |||||||||
| Address1: | 8200 SW 117TH AVE | ||||||||
| Address2: | 304 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331834824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052265651 | ||||||||
| FaxNumber: | 3052262424 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 08/30/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 008432 | FL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 265624800 | 05 | FL | MEDICAID |