Healthcare Provider Details

I. General information

NPI: 1659289304
Provider Name (Legal Business Name): ALANIS MALAVE CARMONA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PROFESSIONAL OFFICE PARK IV997 CALLE SAN ROBERTO
SAN JUAN PR
00926
US

IV. Provider business mailing address

CIUDAD JARDIN CALLE PASEO DORADO 447
CANOVANAS PR
00729
US

V. Phone/Fax

Practice location:
  • Phone: 787-512-0285
  • Fax:
Mailing address:
  • Phone: 787-512-0285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: