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General NPI Number Information
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NPI Number | 1649306143
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Entity Type | Individual
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Provider Name | JACQUELINE VANESSA LUGO PINA
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2046 REPARTO ALTURAS DE PENUELAS I
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City | PENUELAS
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State | PR
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Zip | 00624
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Country | US
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Telephone | 787-239-1275
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Fax | 787-290-1907
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Provider Business Mailing Address
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Address Line | 2046 REPARTO ALTURAS DE PENUELAS 1
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City | PENUELAS
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State | PR
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Zip | 00624
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Country | US
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Telephone | 787-239-1275
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Fax | 787-290-1907
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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 | 003093
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License Number State | PR
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