Healthcare Provider Details

I. General information

NPI: 1437753498
Provider Name (Legal Business Name): FARMACIA BEATRIZ LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 02/26/2021
Certification Date: 02/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. #1 KM 49.0
CIDRA PR
00739-0073
US

IV. Provider business mailing address

HC 71 BOX 7619
CAYEY PR
00736-9575
US

V. Phone/Fax

Practice location:
  • Phone: 407-765-6131
  • Fax:
Mailing address:
  • Phone: 787-714-1111
  • Fax: 787-715-7332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: EDWIN VALENTIN
Title or Position: OWNER
Credential: RPH
Phone: 407-765-6131