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General NPI Number Information
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NPI Number | 1275675928
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Entity Type | Individual
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Provider Name | ZULMA IVELISSE GOMEZ R.PH
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Gender | Female
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | STREET 183 BO. HATO KM 1 SAN LORENZO SHOPPING CENTER
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City | SAN LORENZO
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State | PR
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Zip | 00754
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Country | US
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Telephone | 787-715-1770
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Fax | 787-715-1771
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Provider Business Mailing Address
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Address Line | 440 VIA CAMPINA HACIENDA SAN JOSE
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City | CAGUAS
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State | PR
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Zip | 00727-3098
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Country | US
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Telephone | 787-299-0792
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Fax | 787-715-1771
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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 | 4305
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License Number State | PR
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