Healthcare Provider Details

I. General information

NPI: 1194517227
Provider Name (Legal Business Name): FARMACIA BORIQUEN LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 CALLE LUIS MUNOZ RIVERA STE 6
GUAYANILLA PR
00656-1715
US

IV. Provider business mailing address

268 CALLE LUIS MUNOZ RIVERA STE 6
GUAYANILLA PR
00656-1715
US

V. Phone/Fax

Practice location:
  • Phone: 787-835-3020
  • Fax: 787-835-3020
Mailing address:
  • Phone: 787-835-3020
  • Fax: 787-835-5927

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. WINEL AMAURY SEGARRA TORRES
Title or Position: PHARMACIST IN CHARGE
Credential: PHARMD
Phone: 787-835-3020