Healthcare Provider Details

I. General information

NPI: 1417036658
Provider Name (Legal Business Name): YAMILLE GISELA VARELA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 464 KM 2.3 BO. ACEITUNAS
MOCA PR
00676
US

IV. Provider business mailing address

HC 59 BOX 5517
AGUADA PR
00602-9692
US

V. Phone/Fax

Practice location:
  • Phone: 787-508-3661
  • Fax:
Mailing address:
  • Phone: 787-517-0100
  • Fax: 787-609-6190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4828
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: