Provider Demographics
NPI:1225376031
Name:HERNANDEZ, ALICIA (PHARMACIST)
Entity Type:Individual
Prefix:MISS
First Name:ALICIA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARRETERA 20 KM 3.4 LOS FRAILES
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3481
Mailing Address - Country:US
Mailing Address - Phone:787-790-1400
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 20 KM 3.4 LOS FRAILES
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3481
Practice Address - Country:US
Practice Address - Phone:787-790-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5596183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist