MEDICARE: KENIA Y. WALKER TECHNICIAN

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
1	183700000X	Pharmacy Technician	3662	PR

General Provider Information

NPI Number	:	1326367871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENIA Y. WALKER TECHNICIAN

Provider Business Mailing Address
First Line	:	CALLE LIRIO BUENAVENTURA
Second Line	:	BZN.236
City	:	CAROLINA
State	:	PR
Zip	:	00987
Country	:	US
Telephone Number	:	787-310-0167
Fax Number	:

Provider Business Practice Location Address
First Line	:	AVE. PAZ GRANELA URB. SANTIAGO IGLESIAS
Second Line	:	#1489
City	:	SAN JUAN
State	:	PR
Zip	:	00921
Country	:	US
Telephone Number	:	787-749-0438
Fax Number	:	787-782-8974

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2010
Last Update Date	:	05/24/2010

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