Basic Information
| Provider Information | |||||||||
| NPI: | 1285081430 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUILICHINI OLIVER | ||||||||
| FirstName: | ALEJANDRO | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | COND TAFT | ||||||||
| Address2: | PLAYA GRANDE, 7C | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009112052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873098015 | ||||||||
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| Practice Location | |||||||||
| Address1: | UNIVERSITY DISTRICT HOSPITAL PUERTO RICO MEDICAL CENTER | ||||||||
| Address2: | BO MONACILLOS | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009350001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877540101 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2016 | ||||||||
| LastUpdateDate: | 11/27/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | PR | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RC0000X | 21406 | PR | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.