Provider Demographics
NPI:1437424819
Name:NIEVES-ALVAREZ, MARA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARA
Middle Name:
Last Name:NIEVES-ALVAREZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 CALLE PETIRROJO
Mailing Address - Street 2:URB. MONTEBELLO
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-9465
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:743 CALLE PETIRROJO
Practice Address - Street 2:URB. MONTEBELLO
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-9465
Practice Address - Country:US
Practice Address - Phone:787-448-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5165183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist