Healthcare Provider Details

I. General information

NPI: 1124306311
Provider Name (Legal Business Name): MINERVA FLORES TECNICA DE FARMACIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2011
Last Update Date: 07/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. CORAZONES VILLA SULTANITA CARRETERA ESTATAL #2 BO. SABALOS
MAYAGUEZ PR
00680-0000
US

IV. Provider business mailing address

PO BOX 1570 AVE. CORAZONES VILLA SULTANITA CARRETERA ESTATAL #2 BO. SABALOS
MAYAGUEZ PR
00681-1570
US

V. Phone/Fax

Practice location:
  • Phone: 787-833-8700
  • Fax: 787-265-5155
Mailing address:
  • Phone: 787-833-8700
  • Fax: 787-265-5155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: