Provider Demographics
NPI:1568060861
Name:ALICEA, ALANNA DEL MAR
Entity Type:Individual
Prefix:
First Name:ALANNA
Middle Name:DEL MAR
Last Name:ALICEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND ALTOMONTE 100 CARR 842
Mailing Address - Street 2:APT 68
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9625
Mailing Address - Country:US
Mailing Address - Phone:787-383-8510
Mailing Address - Fax:
Practice Address - Street 1:COND ALTOMONTE 100 CARR 842
Practice Address - Street 2:APT 68
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-9625
Practice Address - Country:US
Practice Address - Phone:787-383-8510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR734111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor