Provider Demographics
NPI:1831581396
Name:RODRIGUEZ-ALICEA, EDITH MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:MARIE
Last Name:RODRIGUEZ-ALICEA
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 1:22140 CARR 113
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-7230
Mailing Address - Country:US
Mailing Address - Phone:787-895-6707
Mailing Address - Fax:787-895-6675
Practice Address - Street 1:2 CARR 140
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-2261
Practice Address - Country:US
Practice Address - Phone:787-846-6829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6294183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist