Healthcare Provider Details

I. General information

NPI: 1689431330
Provider Name (Legal Business Name): ALEX JOSUE DUARTE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2024
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7074 ALLENTOWN RD
CAMP SPRINGS MD
20748-5333
US

IV. Provider business mailing address

5500 FRIENDSHIP BLVD APT N1721
CHEVY CHASE MD
20815-7224
US

V. Phone/Fax

Practice location:
  • Phone: 301-248-9578
  • Fax:
Mailing address:
  • Phone: 786-306-9867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number29635
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number29635
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: