Healthcare Provider Details

I. General information

NPI: 1831772979
Provider Name (Legal Business Name): SUE H ALVAREZ-GUTIERREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 05/05/2021
Certification Date: 04/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

I PALACIOS DEL ESCORIAL APT 1-70
CAROLINA PR
00987
US

IV. Provider business mailing address

I PALACIOS DEL ESCORIAL APT 1-70
CAROLINA PR
00987
US

V. Phone/Fax

Practice location:
  • Phone: 787-373-1978
  • Fax:
Mailing address:
  • Phone: 787-373-1978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number6825
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: