Healthcare Provider Details

I. General information

NPI: 1003296476
Provider Name (Legal Business Name): SHEILA ALEXANDRA NIEVES CUADRADO SR. TECHNICA OF PHARMACY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 06/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 69 BOX 15726
BAYAMON PR
00956-0020
US

IV. Provider business mailing address

HC 69 BOX 15726
BAYAMON PUERTO RICO
00956
UM

V. Phone/Fax

Practice location:
  • Phone: 787-247-0138
  • Fax:
Mailing address:
  • Phone: 787-247-0138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number10003
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: