Healthcare Provider Details

I. General information

NPI: 1659427631
Provider Name (Legal Business Name): JOSE C CUEVAS R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 CALLE DR RAMON E BETANCES S
MAYAGUEZ PR
00680-4061
US

IV. Provider business mailing address

2040 COLS DE ALTURAS DE MAYAGUEZ
MAYAGUEZ PR
00682-6274
US

V. Phone/Fax

Practice location:
  • Phone: 787-832-4102
  • Fax: 787-832-4104
Mailing address:
  • Phone: 787-832-4102
  • Fax: 787-832-4104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4025
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: