Individual provider Active NPI

Elizabeth Alvarez Connelly, M.D.

  • Specialist
  • Miami, FL
National Provider Identifier
1740265339
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME92502 Issued in FL
Practice address
6310 Sunset Dr
Miami, FL 33143-4823
Phone
(305) 669-2799
Fax
(305) 662-5895
NPI assigned
Dec 7, 2005
Last updated
Jun 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME92502 FL Primary

Addresses

Primary practice location

6310 Sunset Dr
Miami, FL 33143-4823

Mailing address

6310 Sunset Dr
Miami, FL 33143-4823
Phone (305) 669-2799

Other identifiers 1

IdentifierTypeStateIssuer
2719541-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sunset Dermatology Skin, Laser & Vein Center, P.a. PastSince Feb 4, 2014 Accepting new patients
The Derm Group LLP PastSince Sep 1, 2019 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1740265339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6310 SUNSET DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331434823",
            "telephone_number": "305-669-2799",
            "fax_number": "305-662-5895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6310 SUNSET DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331434823",
            "telephone_number": "305-669-2799",
            "fax_number": "305-662-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ CONNELLY",
        "first_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME92502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2719541-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.