Provider Demographics
NPI:1730848771
Name:MILAN ALVAREZ, WANDALIZ
Entity type:Individual
Prefix:
First Name:WANDALIZ
Middle Name:
Last Name:MILAN ALVAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 AVE MONTEMAR
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-5559
Mailing Address - Country:US
Mailing Address - Phone:939-254-3570
Mailing Address - Fax:
Practice Address - Street 1:CARR. 172 URB. TURABO GARDENS
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-743-3038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program