Provider Demographics
NPI:1801004338
Name:ALVARADO, LITZY (OTR)
Entity type:Individual
Prefix:MISS
First Name:LITZY
Middle Name:
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE JULIO BENVENUTTY 360 -A COCO NUEVO
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751
Mailing Address - Country:US
Mailing Address - Phone:787-382-0086
Mailing Address - Fax:
Practice Address - Street 1:1274 AVE HOSTOS
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0948
Practice Address - Country:US
Practice Address - Phone:787-813-1972
Practice Address - Fax:787-813-1756
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR761174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist