MEDICARE: MISS WALESKA M. VILLALOBO PHARMACY TECHNICIAN

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
1	183700000X	Pharmacy Technician	4013	PR

General Provider Information

NPI Number	:	1922205533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS WALESKA M. VILLALOBO PHARMACY TECHNICIAN

Provider Business Mailing Address
First Line	:	427 CALLE JARANDILLA
Second Line	:	EMBALSE SAN JOSE
City	:	SAN JUAN
State	:	PR
Zip	:	00923-1704
Country	:	US
Telephone Number	:	787-638-7354
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 CALLE CERRA
Second Line	:	PDA. 15 SANTURCE
City	:	SAN JUAN
State	:	PR
Zip	:	00907-5104
Country	:	US
Telephone Number	:	787-977-8400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	07/08/2007

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