Provider Demographics
NPI:1275392557
Name:LAGARES, ALEXIS (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:LAGARES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LAS BRISAS
Mailing Address - Street 2:41 CALLE LAUREL E
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-9929
Mailing Address - Country:US
Mailing Address - Phone:787-409-2091
Mailing Address - Fax:
Practice Address - Street 1:LAS BRISAS
Practice Address - Street 2:41 CALLE LAUREL E
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-9929
Practice Address - Country:US
Practice Address - Phone:787-409-2091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist