Healthcare Provider Details

I. General information

NPI: 1881804474
Provider Name (Legal Business Name): CARMEN MITI-APONTE B.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CALLE CERRA CDT DR GUALBERTO RABELL
SAN JUAN PR
00907-5104
US

IV. Provider business mailing address

COND. ALBORADA APT. 1232
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 787-721-3220
  • Fax: 787-721-3207
Mailing address:
  • Phone: 787-780-1562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number3116
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: