Provider Demographics
NPI:1316913999
Name:ALICEA-VALENTIN, NANCY E (MD)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:E
Last Name:ALICEA-VALENTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:VILLANOVA
Mailing Address - Street 2:#F1-25 CALLE C
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-274-0527
Mailing Address - Fax:787-764-7963
Practice Address - Street 1:#400 AVE ROOSEVELT SUITE 407
Practice Address - Street 2:CLINICA LAS AMERICAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:878-274-0527
Practice Address - Fax:787-764-7963
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10575208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
F30814Medicare UPIN
PR82932Medicare ID - Type Unspecified