Healthcare Provider Details

I. General information

NPI: 1215303284
Provider Name (Legal Business Name): ENID VALENTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2015
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2428 CALLE LOIZA
SAN JUAN PR
00913-4731
US

IV. Provider business mailing address

2428 CALLE LOIZA
SAN JUAN PR
00913-4731
US

V. Phone/Fax

Practice location:
  • Phone: 787-726-0295
  • Fax: 787-726-8768
Mailing address:
  • Phone: 787-726-0295
  • Fax: 787-726-8768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number7611
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: