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General NPI Number Information
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NPI Number | 1528279262
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Entity Type | Organization
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Legal Business Name | FARMACIA CLETS CENTRO MEDICO
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | FARMACIA CLETS CENTRO MEDICO PASEO JOSE C. BARBOSA BO. MONACILLOS
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City | SAN JUAN
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State | PR
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Zip | 00936-8184
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Country | US
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Telephone | 787-754-8118
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Fax | 787-754-8127
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Provider Business Mailing Address
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Address Line | FARMACIA CLETS CENTRO MEDICO PO BOX 70184
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City | SAN JUAN
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State | PR
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Zip | 00936-8184
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Country | US
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Telephone | 787-754-8118
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Fax | 787-754-8127
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Authorized Official
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Title or Position | REGENT PHARMACIST
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Name | LOURDES MILAGROS FORMES
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Credential | RPH,MPH
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Telephone | 787-754-8118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 07-F-0314
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License Number State | PR
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