Provider Demographics
NPI:1336418284
Name:ALCOCER, VIRGINIA UY
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:UY
Last Name:ALCOCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 BIRNAM TER
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34286-3618
Mailing Address - Country:US
Mailing Address - Phone:941-416-8299
Mailing Address - Fax:
Practice Address - Street 1:15180 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-2742
Practice Address - Country:US
Practice Address - Phone:941-423-6100
Practice Address - Fax:941-423-6700
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 38450183500000X
FLPS38450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist