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General NPI Number Information
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NPI Number | 1134794175
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Entity Type | Organization
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Legal Business Name | LA BOTICA: FARMACIA Y ALGO MAS...LLC
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Dates
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Enumeration Date | 05/21/2021
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Last Update Date | 05/21/2021
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Provider Practice Location Address
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Address Line | CARR NO 20 KM 9.2 BO CAMARONES
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City | GUAYNABO, PR
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State | PR
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Zip | 00970
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Country | US
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Telephone | 178-751-3853
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Fax |
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Provider Business Mailing Address
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Address Line | 1513 CALLE CAVALIERI
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City | SAN JUAN
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State | PR
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Zip | 00927-6122
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Country | US
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Telephone | 787-513-8537
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRENDA YAMILE LIZASUAIN
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Credential | PHARM TECH
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Telephone | 787-513-8537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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