Provider Demographics
NPI:1013666908
Name:ALMODOVAR, NICOLE JULIANE (PHARMD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:JULIANE
Last Name:ALMODOVAR
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:PO BOX 395
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00715-0395
Mailing Address - Country:US
Mailing Address - Phone:787-605-4940
Mailing Address - Fax:
Practice Address - Street 1:396 CALLE SABANERA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2821
Practice Address - Country:US
Practice Address - Phone:787-605-4940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-20
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR61839121835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist