Alvaro Jose Jarquin, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME78476 Issued in FL

Practice address

4404 S Florida Ave
Suite 11
Lakeland, FL 33813-2169

Phone

(863) 937-9148

Fax

(863) 937-9653

NPI assigned

Jun 20, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mondello Family Clinic PA

  • Primary Care Clinic/Center
  • Dundee, FL
  • NPI 1700821121
  NPD (past)

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1275538894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4404 S FLORIDA AVE",
            "address_2": "SUITE 11",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132169",
            "telephone_number": "863-937-9148",
            "fax_number": "863-937-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4404 S FLORIDA AVE",
            "address_2": "SUITE 11",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132169",
            "telephone_number": "863-937-9148",
            "fax_number": "863-937-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARQUIN",
        "first_name": "ALVARO",
        "middle_name": "JOSE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME78476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257915400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dean William Jani, CRNA
• Hunter Joseph Janowiak, DO
• Christa Maria Jansen Van Vuuren, OTR/L
• Janus RX LLC
• Lisa Marie Jardines, MFT
• Navdeep Singh Jassal, MD.
• Asadullah Jat, M.D.
• Ahmed Y Javed, M.D.
• Frances Javier
• Jay Care Medical Center, Inc.

• Family Medicine Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.