Provider Demographics
NPI:1891797114
Name:MALPICA, EVELYN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:
Last Name:MALPICA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A23 CALLE NINFA DEL MAR
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-2121
Mailing Address - Country:US
Mailing Address - Phone:787-278-1872
Mailing Address - Fax:787-796-6052
Practice Address - Street 1:BO. BAIROA CAR. #1 KM. 33.3 ANGORA IND. PARK LOT #4
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-4908
Practice Address - Country:US
Practice Address - Phone:787-286-6052
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4580183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4580OtherPHARMACIST LICENSE