Provider Demographics
NPI:1750448288
Name:ALICEA, ALBERT (RPH)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:ALICEA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:K-5 RIVERSIDE
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683
Mailing Address - Country:US
Mailing Address - Phone:787-892-6763
Mailing Address - Fax:
Practice Address - Street 1:#129 LUIS MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:GUAYANILLA
Practice Address - State:PR
Practice Address - Zip Code:00656-1504
Practice Address - Country:US
Practice Address - Phone:787-835-3525
Practice Address - Fax:787-835-1125
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist