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General NPI Number Information
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NPI Number | 1598805475
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Entity Type | Organization
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Legal Business Name | MISES ABREU CORDERO
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 06/02/2014
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Provider Practice Location Address
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Address Line | CALLE MUNIZ SOUFFRONT STE 459
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City | SAN JUAN
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State | PR
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Zip | 00923
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Country | US
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Telephone | 787-765-8811
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Fax | 787-282-6845
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Provider Business Mailing Address
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Address Line | AVE MUNIZ SOUFFRONT STE 459
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City | RIO PIEDRAS
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State | PR
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Zip | 00923
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Country | US
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Telephone | 787-765-8811
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Fax | 787-282-6845
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Authorized Official
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Title or Position | OWNER
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Name | CARMEN GUILLAMA
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Credential |
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Telephone | 787-765-8811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 15F1117
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License Number State | PR
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