Healthcare Provider Details

I. General information

NPI: 1649291220
Provider Name (Legal Business Name): ERIKA OSSO I
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

B35 CALLE 6 URB SAN FERNANDO
TOA ALTA PR
00953-2205
US

IV. Provider business mailing address

95 CALLE ROBLE HACIENDA MI QUERIDO VIEJO
DORADO PR
00646-2612
US

V. Phone/Fax

Practice location:
  • Phone: 787-501-3577
  • Fax: 787-870-7939
Mailing address:
  • Phone: 787-501-3577
  • Fax: 787-870-7939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number4739
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: