Healthcare Provider Details

I. General information

NPI: 1215966833
Provider Name (Legal Business Name): IRMA NYDIA ALVAREZ PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA #188 IMT #187
LOIZA PR
00772
US

IV. Provider business mailing address

URB SANTA ISIDRA 1 CALLE 5E9
FAJARDO PR
00738
US

V. Phone/Fax

Practice location:
  • Phone: 787-876-2042
  • Fax: 787-256-1900
Mailing address:
  • Phone: 787-863-4947
  • Fax: 787-863-3279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2775
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: