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General NPI Number Information
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NPI Number | 1861682973
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Entity Type | Organization
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Legal Business Name | FARMACIA DIVINA PRESENCIA, INC.
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | CALLE 7 NE, #322 PUERTO NUEVO
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City | SAN JUAN
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State | PR
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Zip | 00920
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Country | US
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Telephone | 787-782-0489
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Fax | 787-781-8273
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Provider Business Mailing Address
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Address Line | PO BOX 70344 PMB # 94
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City | SAN JUAN
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State | PR
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Zip | 00936
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Country | US
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Telephone | 787-782-0489
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Fax | 787-781-8273
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Authorized Official
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Title or Position | D.R
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Name | DR. NORMA WILLIAMS SUAREZ
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Credential | M.D
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Telephone | 787-782-0489
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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 | 09-F-2525
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License Number State | PR
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