Healthcare Provider Details

I. General information

NPI: 1184705352
Provider Name (Legal Business Name): MI FARMACIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA 179 KM 0.3 SECTOR LINEA CAPO
GUAYAMA PR
00784
US

IV. Provider business mailing address

PO BOX 2247
GUAYAMA PR
00785-2247
US

V. Phone/Fax

Practice location:
  • Phone: 787-866-2088
  • Fax: 787-866-6051
Mailing address:
  • Phone: 787-866-2088
  • Fax: 787-866-6051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number07-F-1919
License Number StatePR

VIII. Authorized Official

Name: MRS. ELIZABETH B VELOZO
Title or Position: PRESIDENT
Credential:
Phone: 787-866-2088