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General NPI Number Information
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NPI Number | 1609066877
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Entity Type | Individual
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Provider Name | MARLENE LIZBETH SUBILLAGA
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Gender | Female
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | COND. GOLDEN TOWER C8 AVE. PONTEZUELA
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City | CAROLINA
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State | PR
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Zip | 00983
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Country | US
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Telephone | 787-769-5240
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Fax | 787-757-0021
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Provider Business Mailing Address
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Address Line | CALLE 436 MY 18 COUNTRY CLUB CUARTA EXTENCION
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City | CAROLINA
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State | PR
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Zip | 00983
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Country | US
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Telephone | 939-969-0712
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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 | 4845
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License Number State | PR
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