Healthcare Provider Details

I. General information

NPI: 1477012888
Provider Name (Legal Business Name): OLGA IRIS ADORNO R.PH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2019
Last Update Date: 03/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

K 24 CALLE 1 URB VALPARAISO
TOA BAJA PR
00949
US

IV. Provider business mailing address

K 24 CALLE 1 URB VALPARAISO
TOA BAJA PR
00949
US

V. Phone/Fax

Practice location:
  • Phone: 787-248-8356
  • Fax:
Mailing address:
  • Phone: 787-248-8356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2845
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: