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General NPI Number Information
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NPI Number | 1376751842
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Entity Type | Individual
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Provider Name | MAYRA LEE ROSARIO F.A.
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Gender | Female
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | CALLE ALGARIN ESQUINA DR. BARRERAS
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City | JUNCOS
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State | PR
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Zip | 00777-9706
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Country | US
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Telephone | 939-579-7205
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Fax |
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Provider Business Mailing Address
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Address Line | BO. PLACITA HC01 BOX 5816
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City | JUNCOS
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State | PR
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Zip | 00777-9706
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Country | US
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Telephone | 939-579-7205
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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 | 003593
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License Number State | PR
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