Healthcare Provider Details

I. General information

NPI: 1902560782
Provider Name (Legal Business Name): LIZETTE VERA-RAMIREZ PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2021
Last Update Date: 10/27/2021
Certification Date: 10/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO COMERCIAL PONCE DE LEON AVE ESMERALDA
GUAYNABO PR
00969
US

IV. Provider business mailing address

E 13 CLEVELAND ST., PARKVILLE
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-720-4035
  • Fax: 787-720-2419
Mailing address:
  • Phone: 787-528-1110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3900
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: