Healthcare Provider Details

I. General information

NPI: 1316923840
Provider Name (Legal Business Name): MARIBEL OQUENDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 176 ESQ SAN CLAUDIO SAN GENARO 352
SAN JUAN PR
00926
US

IV. Provider business mailing address

1680 CALLE HIDALGO VENUS GARDENS
SAN JUAN PR
00926-4646
US

V. Phone/Fax

Practice location:
  • Phone: 787-760-1280
  • Fax: 787-283-3673
Mailing address:
  • Phone: 787-760-1280
  • Fax: 787-283-3673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number3325
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: