Healthcare Provider Details

I. General information

NPI: 1033370770
Provider Name (Legal Business Name): YOLANDA VAZQUEZ SANTIAGO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 CALLE GEORGETTI ESQ. SANTIAGO R. PALMER
COMERIO PR
00782-2537
US

IV. Provider business mailing address

PO BOX 686
COMERIO PR
00782-0686
US

V. Phone/Fax

Practice location:
  • Phone: 787-875-2121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number002302
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: