Healthcare Provider Details

I. General information

NPI: 1457534109
Provider Name (Legal Business Name): VIVIAN L. ROGERS SANCHEZ R.PH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE F A15 URB JACARANDA
PONCE PR
00730-1604
US

IV. Provider business mailing address

CALLE F A15 URB JACARANDA
PONCE PR
00730-1604
US

V. Phone/Fax

Practice location:
  • Phone: 787-409-3011
  • Fax: 787-844-2101
Mailing address:
  • Phone: 787-409-3011
  • Fax: 787-844-2101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number003867
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number003867
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number003767
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: