Provider Demographics
NPI:1871590828
Name:PEA-ALVARADO, ZAIDA (DMD)
Entity type:Individual
Prefix:DR
First Name:ZAIDA
Middle Name:
Last Name:PEA-ALVARADO
Suffix:
Gender:F
Credentials:DMD
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 2109
Mailing Address - Street 2:
Mailing Address - City:OROCOVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00720-2109
Mailing Address - Country:US
Mailing Address - Phone:787-867-4228
Mailing Address - Fax:787-867-4228
Practice Address - Street 1:9 CALLE HOSPITAL
Practice Address - Street 2:
Practice Address - City:OROCOVIS
Practice Address - State:PR
Practice Address - Zip Code:00720-4404
Practice Address - Country:US
Practice Address - Phone:787-867-4228
Practice Address - Fax:787-867-4228
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR41582Medicare UPIN
PRD-0812Medicare UPIN
PR720024Medicare UPIN
PRDN-1714Medicare UPIN
PRJ1332Medicare UPIN