Provider Demographics
NPI:1194468777
Name:CHAVES, AALYAH STEPHANIE
Entity Type:Individual
Prefix:
First Name:AALYAH
Middle Name:STEPHANIE
Last Name:CHAVES
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:URBANIZACION MANSIONES CALLE MONACO
Mailing Address - Street 2:3054 CARRETERA 100
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623
Mailing Address - Country:US
Mailing Address - Phone:787-673-3814
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION MANSIONES CALLE MONACO
Practice Address - Street 2:C 33 CARRETERA 100
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:787-673-3814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6938183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist