Healthcare Provider Details

I. General information

NPI: 1700709839
Provider Name (Legal Business Name): MARILEA FAS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 CALLE BARBOSA
CABO ROJO PR
00623-4005
US

IV. Provider business mailing address

3253 CALLE PALM BCH # K27
CABO ROJO PR
00623-8991
US

V. Phone/Fax

Practice location:
  • Phone: 787-851-1270
  • Fax: 787-255-2050
Mailing address:
  • Phone: 787-851-1270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5185
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: