Healthcare Provider Details

I. General information

NPI: 1063379329
Provider Name (Legal Business Name): NEIDA MARITZA HEREDIA TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 4 BOX 13749
ARECIBO PR
00612-9223
US

IV. Provider business mailing address

HC 4 BOX 13749
ARECIBO PR
00612-9223
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-4449
  • Fax:
Mailing address:
  • Phone: 787-884-4449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2994
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: