Provider Demographics
NPI:1952584849
Name:CAPELLAN, ALEXANDRA (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:CAPELLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 CALLE SALUD
Mailing Address - Street 2:EDIFICIO THAMAR 3B
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-5803
Mailing Address - Country:US
Mailing Address - Phone:787-223-2592
Mailing Address - Fax:787-709-4651
Practice Address - Street 1:1440 CALLE SALUD
Practice Address - Street 2:EDIFICIO TAMAR 3B
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-5803
Practice Address - Country:US
Practice Address - Phone:787-223-2592
Practice Address - Fax:787-709-4651
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16948208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice