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General NPI Number Information
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NPI Number | 1043504269
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Entity Type | Individual
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Provider Name | VIVIENNE MARIE MARRERO-BAUZA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/06/2011
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Last Update Date | 06/06/2011
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Provider Practice Location Address
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Address Line | PLAZA JUANA DIAZ CARRETERA 149 INTERSECCION CARRETERA 584 Y 52
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City | JUANA DIAZ
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State | PR
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Zip | 00795-0000
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Country | US
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Telephone | 787-837-7090
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Fax | 787-837-7090
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Provider Business Mailing Address
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Address Line | PO BOX 445
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City | MERCEDITA
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State | PR
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Zip | 00715-0445
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Country | US
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Telephone | 787-718-9153
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5454
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License Number State | PR
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