Healthcare Provider Details

I. General information

NPI: 1053274514
Provider Name (Legal Business Name): NILKA ADEI CRUZ JUSINO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CALLE COMERCIO
HORMIGUEROS PR
00660-1803
US

IV. Provider business mailing address

210 CALLE LOTO REPARTO SURIS
SAN GERMAN PR
00683
US

V. Phone/Fax

Practice location:
  • Phone: 787-849-4173
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8568
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: