1053534008 NPI number — MARANGELIE RODRIGUEZ FARMACY TECNICIAN

Table of content: MARANGELIE RODRIGUEZ FARMACY TECNICIAN (NPI 1053534008)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053534008 NPI number — MARANGELIE RODRIGUEZ FARMACY TECNICIAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RODRIGUEZ
Provider First Name:
MARANGELIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FARMACY TECNICIAN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053534008
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
VILLAS DE LOIZA CALLE 39 MM 11
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANOVANAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00729
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-876-9262
Provider Business Mailing Address Fax Number:
787-860-8379

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
64 CALLE DIEGO ZALDUONDO N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAJARDO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00738-4711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-860-8888
Provider Business Practice Location Address Fax Number:
787-860-8379
Provider Enumeration Date:
04/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183700000X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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