Provider Demographics
NPI:1205389202
Name:ALVAREZ, HENDRIKA IVELISSE (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:HENDRIKA
Middle Name:IVELISSE
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 CALLE TABONUCO
Mailing Address - Street 2:CITY PARADISE
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617
Mailing Address - Country:US
Mailing Address - Phone:787-414-4745
Mailing Address - Fax:
Practice Address - Street 1:26 CALLE TABONUCO
Practice Address - Street 2:CITY PARADISE
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-2743
Practice Address - Country:US
Practice Address - Phone:787-414-4745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR011474183700000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy