Healthcare Provider Details

I. General information

NPI: 1609029412
Provider Name (Legal Business Name): FARMACIA UPR-CTU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 10/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GAMMA PROJECT CARDIOVASCULAR CTR FL 8 SUITE 837
SAN JUAN PR
00935-0001
US

IV. Provider business mailing address

GAMMA PROJECT CARDIOVASCULAR CTR FL 8 SUITE 837
SAN JUAN PR
00935-0001
US

V. Phone/Fax

Practice location:
  • Phone: 787-759-9595
  • Fax: 787-754-5564
Mailing address:
  • Phone: 787-759-9595
  • Fax: 787-754-5564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number StatePR

VIII. Authorized Official

Name: DR. CARMEN D ZORRILLA
Title or Position: PRINCIPAL INVESTIGATOR
Credential: M.D.
Phone: 787-759-9595