Healthcare Provider Details

I. General information

NPI: 1104648385
Provider Name (Legal Business Name): DIANA E TOLEDO ALVAREZ PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 CALLE LUIS MUNOZ RIVERA
GUAYANILLA PR
00656-1841
US

IV. Provider business mailing address

516 CALLE MANUEL G TAVARES
PONCE PR
00728-2510
US

V. Phone/Fax

Practice location:
  • Phone: 787-835-2370
  • Fax:
Mailing address:
  • Phone: 939-257-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6447
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: