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General NPI Number Information
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NPI Number | 1891836623
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Entity Type | Organization
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Legal Business Name | NIRO 2011 LLC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | AVE. GENERAL VALERO # 305
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City | FAJARDO
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State | PR
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Zip | 00738
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Country | US
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Telephone | 787-863-7788
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Fax | 787-863-1422
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Provider Business Mailing Address
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Address Line | AVE GENERAL VALERO #305
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City | FAJARDO
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State | PR
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Zip | 00738
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Country | US
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Telephone | 787-863-7788
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Fax | 787-863-1422
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | GIL NIEVES
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Credential | PHARM D
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Telephone | 787-403-0508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 07-F-0366
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License Number State | PR
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