Individual
JORGE LUIS ALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MEDICO CIRUJANO
Contact information
Practice address
7051 DR PHILLIPS BLVD STE 7, ORLANDO, FL 32819-5140
(407) 249-1234
(407) 249-1755
Mailing address
11513 LAKE UNDERHILL RD, ORLANDO, FL 32825-5001
(407) 249-1234
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
14864-I
PR
208000000X
Pediatrics Physician
Primary
ME149151
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110476500
—
FL
Enumeration date
07/28/2018
Last updated
07/02/2021
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