Healthcare Provider Details

I. General information

NPI: 1366760753
Provider Name (Legal Business Name): BRENDA GARCIA PHARMACY TEC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2010
Last Update Date: 05/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 05 BOX55237 SAN ANTONIO
CAGUAS PR
00725
US

IV. Provider business mailing address

HC05 BOX 55237 BO SAN ANTONIO
CAGUAS PR
00725
US

V. Phone/Fax

Practice location:
  • Phone: 787-316-8737
  • Fax: 787-657-3550
Mailing address:
  • Phone: 787-316-8737
  • Fax: 787-657-3550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number5243
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: