Provimely Alvarez, M.D.
Individual provider Active NPI General Practice Physician · Gurabo, PR
NPI 1598920175 · NPPES record last updated Oct 20, 2020
Key facts
- NPI
- 1598920175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 17241 (PR)
- Practice address
- Plaza Gurabo
Carr 189
Gurabo, PR 00778 - Phone
- (787) 861-7777
- NPI assigned
- Jul 23, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080902000147 | PR | Practitioner - General Practice | 5193891976 | Practice locations: Gurabo, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South-Central Emergency Group LLC | General Practice | Current |
Accepting new patients |
| Ra MD Services | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 17241 | PR | Yes |
Addresses
Primary practice location
Plaza Gurabo
Carr 189
Gurabo, PR 00778
Mailing address
PO Box 3504
Juncos, PR 00777-6504
Phone (787) 676-7020
Other providers in Gurabo, PR
- Albita S Lab Corporation
- Omar Enrique Alicea-Velez
- Iliana Alicea
- Alpha Physician Group Corp
- Jean Carlos Alvarez Gonzalez
- Reina Andujar
- Michell Aponte - Soto
- Camille Monique Aponte Melero
- Aydil Aponte-Soto
- Ovidio Arizmendi Jr.
All providers in Gurabo, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.