Provider Demographics
NPI:1922449396
Name:ALEJANDRO, MARILYN (RPH)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:ALEJANDRO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 S OCEAN DR APT 1809
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7694
Mailing Address - Country:US
Mailing Address - Phone:954-591-9054
Mailing Address - Fax:
Practice Address - Street 1:1830 S OCEAN DR
Practice Address - Street 2:APT 1809
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-7694
Practice Address - Country:US
Practice Address - Phone:954-591-9054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS44337183500000X
CO19189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist