=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346004538
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GRACE MARIE OLAN GARCIA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/08/2024
-----------------------------------------------------
Last Update Date | 02/08/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | URB EL RETIRO #13 CALLE PRINCIPAL
-----------------------------------------------------
City | SAN GERMAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00683
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-892-1485
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | URB. MANSIONES MONTERREY 560 CALLE MADRID
-----------------------------------------------------
City | YAUCO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00698
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-543-1937
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 8179
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------