Provider Demographics
NPI:1881573673
Name:GONZALES, ALEA MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:ALEA
Middle Name:MARIE
Last Name:GONZALES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 CENTRAL AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104-1143
Mailing Address - Country:US
Mailing Address - Phone:505-427-1970
Mailing Address - Fax:
Practice Address - Street 1:1815 CENTRAL AVE NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87104-1143
Practice Address - Country:US
Practice Address - Phone:505-247-4141
Practice Address - Fax:505-843-6249
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00010378183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist