Provider Demographics
NPI:1326510421
Name:ALICEA, NANCY B (ND)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:B
Last Name:ALICEA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 AVE ROBERTO DIAZ
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-5105
Mailing Address - Country:US
Mailing Address - Phone:787-503-5827
Mailing Address - Fax:
Practice Address - Street 1:179 AVE LUIS MUNOZ RIVERA S
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4704
Practice Address - Country:US
Practice Address - Phone:787-263-9260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-30
Last Update Date:2018-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR56175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath