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General NPI Number Information
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NPI Number | 1932574191
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Entity Type | Organization
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Legal Business Name | FARMACIA ISLA VERDE
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Dates
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Enumeration Date | 12/14/2015
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Last Update Date | 12/29/2016
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Provider Practice Location Address
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Address Line | 1035 CALLE MAR AMARILLO MARGINAL VILLAMAR AO16 ISLA VERDE
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City | CAROLINA
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State | PR
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Zip | 00979
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Country | US
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Telephone | 787-548-7559
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Fax |
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Provider Business Mailing Address
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Address Line | 3409 AVE ISLA VERDE APT 602
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City | CAROLINA
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State | PR
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Zip | 00979-4970
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Country | US
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Telephone | 787-548-7559
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRENDA CRUZ
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Credential | PHARMD
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Telephone | 787-548-7559
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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 | 18-F-3407
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License Number State | PR
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