Provider Demographics
NPI:1003475393
Name:ALANCASTRO, WALESKA
Entity Type:Individual
Prefix:MRS
First Name:WALESKA
Middle Name:
Last Name:ALANCASTRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 4022
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601-9570
Mailing Address - Country:US
Mailing Address - Phone:787-549-0922
Mailing Address - Fax:787-879-3666
Practice Address - Street 1:1400 AVE MIRAMAR STE 18
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-2747
Practice Address - Country:US
Practice Address - Phone:787-879-3696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3197183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician