Provider Demographics
NPI:1265767727
Name:ALEJANDRO, ANGEL MANUEL (PHARMACY TECHNITIAN)
Entity type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:MANUEL
Last Name:ALEJANDRO
Suffix:
Gender:M
Credentials:PHARMACY TECHNITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RES. MONTE HATILLO EDIF. 29
Mailing Address - Street 2:APT. 362
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:787-365-1673
Mailing Address - Fax:
Practice Address - Street 1:124 AVE WINSTON CHURCHILL
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6064
Practice Address - Country:US
Practice Address - Phone:787-296-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7730183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician