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General NPI Number Information
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NPI Number | 1902806912
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Entity Type | Individual
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Provider Name | MISS JESSICA IVETTE VILLEGAS RUIZ
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Gender | Female
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Dates
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Enumeration Date | 08/01/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 19 CALLE ACUARIO SUITE 16
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City | SAN JUAN
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State | PR
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Zip | 00926-4902
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Country | US
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Telephone | 787-761-4990
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Fax | 787-748-1935
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Provider Business Mailing Address
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Address Line | AM18 CALLE 29 INTERAMERICANA
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976-3423
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Country | US
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Telephone | 787-439-1777
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Fax |
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 004015
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License Number State | PR
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