Healthcare Provider Details

I. General information

NPI: 1275660912
Provider Name (Legal Business Name): EMILIO E SANZ PH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE AGUSTIN RAMOS CALERO INT 111
ISABELA PR
00662
US

IV. Provider business mailing address

PO BOX 142195
ARECIBO PR
00614
US

V. Phone/Fax

Practice location:
  • Phone: 787-830-2705
  • Fax: 787-830-0465
Mailing address:
  • Phone: 787-830-2705
  • Fax: 787-830-0465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4476
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: