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General NPI Number Information
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NPI Number | 1730234899
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Entity Type | Individual
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Provider Name | MAYTE LUCIELE VIZCARRONDO
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Gender | Female
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | CALLE IGNACIO ARZUAGA #5-E
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City | CAROLINA
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State | PR
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Zip | 00985
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Country | US
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Telephone | 787-769-0058
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Fax | 787-768-0855
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Provider Business Mailing Address
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Address Line | 107 COND ANDALUCIA APT 3103
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City | CAROLINA
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State | PR
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Zip | 00987-2326
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Country | US
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Telephone | 787-630-7989
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Fax | 787-768-0855
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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 | 5103
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License Number State | PR
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