Healthcare Provider Details

I. General information

NPI: 1952047615
Provider Name (Legal Business Name): FARMALAB HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2022
Last Update Date: 07/29/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR #1 AVE SAKURA VILLA BLANCA INDUSTRIAL PARK PLAZA BAIROA SUITE 115
CAGUAS PR
00725
US

IV. Provider business mailing address

PO BOX 191855
SAN JUAN PR
00919-1855
US

V. Phone/Fax

Practice location:
  • Phone: 787-979-3111
  • Fax: 787-979-3110
Mailing address:
  • Phone: 787-979-3111
  • Fax: 787-979-3110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEXANDRA AMARO ORTIZ
Title or Position: ADMINISTRATOR
Credential: PHD
Phone: 787-342-4736