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NPI Code Detail

MEDICARE: DR. MADERIC J BERIGUETE MIRANDA PHARM D

MEDICARE: DR. MADERIC J BERIGUETE MIRANDA PHARM D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist5305PR

General Provider Information

NPI Number : 1043857766
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MADERIC J BERIGUETE MIRANDA PHARM D
Provider Business Mailing Address
First Line : PO BOX 1310
Second Line :
City : RIO GRANDE
State : PR
Zip : 00745-1310
Country : US
Telephone Number : 787-479-2862
Fax Number :
Provider Business Practice Location Address
First Line : 2550 AVE DE DIEGO
Second Line :
City : CAROLINA
State : PR
Zip : 00987-4800
Country : US
Telephone Number : 787-762-8412
Fax Number : 787-762-8479
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2019
Last Update Date : 12/02/2019

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