Organization Active NPI

Edel Alvarez MD LLC

  • Primary Care Clinic/Center
  • Clearwater, FL
National Provider Identifier
1093393993
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
EDEL ALVAREZ MD LLC
Practice address
2878 Roosevelt Blvd
Clearwater, FL 33760-1923
Phone
(727) 474-3442
NPI assigned
Mar 31, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Edel Alvarez, MD
Title
Owner/Physician
Phone
(727) 474-3442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2878 Roosevelt Blvd
Clearwater, FL 33760-1923

Mailing address

5512 18TH St NE
St Petersburg, FL 33703-1731
Phone (813) 453-7931

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RebeccaLaurenAPRN@hushmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210701001716 FL Part B Supplier - Clinic/Group Practice 2567863228 Receives reassigned benefits from 1 practitioner
Practice locations: St Petersburg, FL; Clearwater, FL

National Provider Directory

National Provider Directory

Locations

13920 58th St N
Ste 1006
Clearwater, FL 33760
Phone (813) 453-7931

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1093393993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 18TH ST NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337031731",
            "telephone_number": "813-453-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2878 ROOSEVELT BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337601923",
            "telephone_number": "727-474-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEL ALVAREZ MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "EDEL",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "727-474-3442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RebeccaLaurenAPRN@hushmail.com",
            "affiliation": "N",
            "address_1": "2878 Roosevelt Blvd",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337601923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.