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General NPI Number Information
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NPI Number | 1275541260
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Entity Type | Individual
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Provider Name | DIMARYS ESCUDERO PT
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 11/13/2014
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Provider Practice Location Address
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Address Line | CARR. 160 KM 4.5 BO ALMIRANTE NORTE
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-917-0603
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Fax | 787-917-0688
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Provider Business Mailing Address
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Address Line | CALLE LOS MILAGROS #9
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City | CIALES
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State | PR
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Zip | 00638
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Country | US
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Telephone | 787-599-1114
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 5587
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License Number State | PR
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