Provider Demographics
NPI:1801098223
Name:ALEJANDRO, SAMARIE (ATO)
Entity type:Individual
Prefix:
First Name:SAMARIE
Middle Name:
Last Name:ALEJANDRO
Suffix:
Gender:F
Credentials:ATO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:D26 CALLE 5
Mailing Address - Street 2:RIO GRANDE STATE
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-5033
Mailing Address - Country:US
Mailing Address - Phone:787-632-2402
Mailing Address - Fax:787-755-2222
Practice Address - Street 1:D26 CALLE 5
Practice Address - Street 2:RIO GRANDE STATE
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-5033
Practice Address - Country:US
Practice Address - Phone:787-632-2402
Practice Address - Fax:787-755-2222
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR732390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program