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General NPI Number Information
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NPI Number | 1467609586
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Entity Type | Individual
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Provider Name | MARITZA CARDONA-MATOS CPHT
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Gender | Female
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Dates
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Enumeration Date | 08/20/2008
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | AVE JESUS T PINEDO 280 SUIT B CVS SPECIALTY PHARMACY
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City | RIO PIEDRAS
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State | PR
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Zip | 00927
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Country | US
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Telephone | 787-759-4018
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 112 BOX 5005
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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 | 787-759-4018
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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 | 2198
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License Number State | PR
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