Basic Information
| Provider Information | |||||||||
| NPI: | 1447706320 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALICEA | ||||||||
| FirstName: | ZOE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1528 CALLE EMPERATRIZ | ||||||||
| Address2: | VALLE REAL | ||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007160501 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 917 AVE TITO CASTRO | ||||||||
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| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007310501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878442080 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2016 | ||||||||
| LastUpdateDate: | 08/30/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 32283R | PR | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.