Healthcare Provider Details

I. General information

NPI: 1255464103
Provider Name (Legal Business Name): FARMACIA CDT DR. CAPARROS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ESQUINA CALLE ANTONOIO BARCELO AVENIDA MORELL
UTUADO PR
00641
US

IV. Provider business mailing address

CALLE BETANCES #2
UTUADO PA
00641
US

V. Phone/Fax

Practice location:
  • Phone: 787-814-1129
  • Fax: 787-894-5731
Mailing address:
  • Phone: 787-894-2288
  • Fax: 787-894-5731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number07-F-1499
License Number StatePR

VIII. Authorized Official

Name: MARISOL GONZALEZ
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 787-894-2288