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NPI Code Detail

MEDICARE: RECETA A SU PUERTA INC

MEDICARE: RECETA A SU PUERTA INC
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
13336C0003XCommunity/Retail Pharmacy18-F-2594PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12129754OTHERPK

General Provider Information

NPI Number : 1457487159
Entity Type Code : Organization
Provider Name (Legal Business Name) : RECETA A SU PUERTA INC
Provider Business Mailing Address
First Line : 251 CALLE ROBLE
Second Line :
City : SAN JUAN
State : PR
Zip : 00925-3104
Country : US
Telephone Number : 787-765-1211
Fax Number : 787-765-1576
Provider Business Practice Location Address
First Line : 251 CALLE ROBLE
Second Line :
City : SAN JUAN
State : PR
Zip : 00925-3104
Country : US
Telephone Number : 787-751-6312
Fax Number : 787-250-8661
Authorized Official
Title or Position : PIC / OWNER
Name : MIRTA RAMIREZ
Credential :
Telephone Number : 787-765-1211
Provider Enumeration Date : 02/26/2007
Last Update Date : 03/14/2016

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Directions to “RECETA A SU PUERTA INC ” Practice Location

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