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NPI Code Detail

MEDICARE: NICOLE MEDINA PHARMD

MEDICARE:   NICOLE  MEDINA  PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist6731PR

General Provider Information

NPI Number : 1093353617
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE MEDINA PHARMD
Provider Business Mailing Address
First Line : PALACIOS REALES 271 CALLE MINIVE
Second Line :
City : TOA ALTA
State : PR
Zip : 00953
Country : US
Telephone Number : 787-679-2731
Fax Number :
Provider Business Practice Location Address
First Line : 150 CALLE F VIZCARRONDO
Second Line :
City : SAN JUAN
State : PR
Zip : 00926-4483
Country : US
Telephone Number : 787-755-1375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2019
Last Update Date : 12/13/2019

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Directions to “ NICOLE MEDINA PHARMD” Practice Location

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