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General NPI Number Information
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NPI Number | 1942064712
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Entity Type | Individual
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Provider Name | RAUL QUESADA
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Gender | Male
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Dates
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Enumeration Date | 02/12/2024
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 40 MUNOZ RIVERA ST
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City | SANTA ISABEL
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State | PR
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Zip | 00757
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Country | US
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Telephone | 787-845-3030
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Fax | 787-845-5428
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Provider Business Mailing Address
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Address Line | 108 CALLE VICTORIA
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City | PONCE
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State | PR
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Zip | 00730-3767
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Country | US
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Telephone | 787-259-5233
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Fax | 787-842-4671
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2210
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License Number State | PR
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