=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104648385
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DIANA E TOLEDO ALVAREZ PHARM D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/29/2024
-----------------------------------------------------
Last Update Date | 10/29/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 160 CALLE LUIS MUNOZ RIVERA
-----------------------------------------------------
City | GUAYANILLA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00656-1841
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-835-2370
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 516 CALLE MANUEL G TAVARES
-----------------------------------------------------
City | PONCE
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00728-2510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 939-257-9999
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 6447
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------