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General NPI Number Information
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NPI Number | 1154082014
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Entity Type | Individual
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Provider Name | KEYSHLA TUBENS
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Gender | Female
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Dates
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Enumeration Date | 01/04/2022
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 10 AVE FENWAL
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City | SAN GERMAN
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State | PR
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Zip | 00683-4476
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Country | US
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Telephone | 787-892-4406
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Fax |
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Provider Business Mailing Address
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Address Line | PASEO DEL VALLE CASA G4
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City | ANASCO
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State | PR
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Zip | 00610
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Country | US
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Telephone | 787-329-3216
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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 | 6969
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License Number State | PR
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