=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861695850
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ZOILA RAQUEL ENCARNACION CPHT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/07/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 963 CALLE MUNOZ RIVERA
-----------------------------------------------------
City | PENUELAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00624-1401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-836-2173
-----------------------------------------------------
Fax | 787-836-6102
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | HC 2 BOX 4965
-----------------------------------------------------
City | PENUELAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00624-9604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-836-3573
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183700000X
-----------------------------------------------------
Taxonomy Name | Pharmacy Technician
-----------------------------------------------------
License Number | 5883
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------