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NPI 1508467531

NPI 1508467531 : DIANA M TORRES FAJARDO PHARMD : CAROLINA, PR

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General NPI Number Information
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    NPI Number           |    1508467531
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    Entity Type          |    Individual 
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    Provider Name        |    DIANA M TORRES FAJARDO PHARMD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/05/2020
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    Last Update Date     |    06/16/2021
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Provider Practice Location Address
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    Address Line         |    9546 CALLE DIAZ WAY APT 421 
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    City                 |    CAROLINA
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    State                |    PR
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    Zip                  |    00979
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    Country              |    US
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    Telephone            |    787-525-5737
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9546 CALLE DIAZ WAY APT 421 
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    City                 |    CAROLINA
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    State                |    PR
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    Zip                  |    00979
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    Country              |    US
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    Telephone            |    787-525-5737
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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        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    6812
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    License Number State |    PR
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Taxonomy #2
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    61819
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    License Number State |    FL
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