Provider Demographics
NPI:1982984605
Name:ALCAIDE MOLINA, LISANDRA (DC)
Entity Type:Individual
Prefix:DR
First Name:LISANDRA
Middle Name:
Last Name:ALCAIDE MOLINA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-0219
Mailing Address - Country:US
Mailing Address - Phone:787-544-5100
Mailing Address - Fax:
Practice Address - Street 1:272 CALLE MARGINAL
Practice Address - Street 2:SUITE 2
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-2421
Practice Address - Country:US
Practice Address - Phone:787-544-5100
Practice Address - Fax:787-544-5100
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR493111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor