Healthcare Provider Details

I. General information

NPI: 1932230133
Provider Name (Legal Business Name): ELBA N MARRERO BERRIOS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 CALLE GEORGETTI
COMERIO PR
00782-2540
US

IV. Provider business mailing address

75 CALLE GEORGETTI
COMERIO PR
00782-2540
US

V. Phone/Fax

Practice location:
  • Phone: 787-875-2255
  • Fax: 787-875-2255
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1868
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: