Provider Demographics
NPI:1316089048
Name:OLIVERAS, ALBA M (PHARMACIST)
Entity type:Individual
Prefix:
First Name:ALBA
Middle Name:M
Last Name:OLIVERAS
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 25557
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-9753
Mailing Address - Country:US
Mailing Address - Phone:787-855-4639
Mailing Address - Fax:787-855-4639
Practice Address - Street 1:CENTRO COM. PUERTA DEL SOL CARR. MUN.2
Practice Address - Street 2:SUITE-1
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-4444
Practice Address - Fax:787-884-4444
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist