Provider Demographics
NPI:1588692339
Name:ALICEA, DHILMA L (MD)
Entity type:Individual
Prefix:DR
First Name:DHILMA
Middle Name:L
Last Name:ALICEA
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:PO BOX 4960
Mailing Address - Street 2:PMB #475
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4960
Mailing Address - Country:US
Mailing Address - Phone:787-258-5205
Mailing Address - Fax:787-286-6622
Practice Address - Street 1:#50 LUIS MUHOZ MARIN AVE
Practice Address - Street 2:STE 305 QUADRANGLE MEDICAL CENTER
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-0857
Practice Address - Fax:787-286-6622
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR124862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRPG1060OtherPALIC
PR89821ALOtherTRIPLES
H82257Medicare UPIN
PRPG1060OtherPALIC