=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891915781
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WANDA I BATISTA RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2007
-----------------------------------------------------
Last Update Date | 01/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | PR-1 AVE SAKURA, VILLA BLANCA INDUSTRIAL PARK PLAZA BAIROA SUITE 115
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-979-3111
-----------------------------------------------------
Fax | 787-979-3110
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 AVE FOMENTO PLAZA BAIROA SUITE 7
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-579-0587
-----------------------------------------------------
Fax | 787-720-5135
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 4308
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------