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NPI 1437205036

NPI 1437205036 : MYRNA GOMEZ RPH : CEIBA, PR

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General NPI Number Information
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    NPI Number           |    1437205036
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    Entity Type          |    Individual 
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    Provider Name        |    MYRNA GOMEZ RPH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/26/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    AVE LAURO PINERO 266 
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    City                 |    CEIBA
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    State                |    PR
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    Zip                  |    00735-0266
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    Country              |    US
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    Telephone            |    787-885-3010
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    Fax                  |    787-885-1595
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Provider Business Mailing Address
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    Address Line         |    PO BOX 244 
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    City                 |    CEIBA
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    State                |    PR
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    Zip                  |    00735-0244
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    Country              |    US
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    Telephone            |    787-850-7232
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    Fax                  |    787-885-1595
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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       |    2372
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    License Number State |    PR
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