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General NPI Number Information
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NPI Number | 1366869877
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Entity Type | Individual
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Provider Name | MR. PEDRO JORGE LAUREANO
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Gender | Male
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Dates
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Enumeration Date | 03/21/2014
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Last Update Date | 03/21/2014
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Provider Practice Location Address
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Address Line | BU-1 BAIROA AVE LAS AMERICAS
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 787-743-6434
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4960 PMB 261
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City | CAGUAS
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State | PR
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Zip | 00726-4960
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Country | US
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Telephone | 787-640-8809
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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 | 8528
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License Number State | PR
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