MEDICARE: MARIA V CARRASQUILLO

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	183500000X	Pharmacist	2508	PR

General Provider Information

NPI Number	:	1922677673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA V CARRASQUILLO

Provider Business Mailing Address
First Line	:	PO BOX 271
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00726-0271
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 CALLE JAZMIN
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00725-2469
Country	:	US
Telephone Number	:	787-286-9055
Fax Number	:

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

Provider Enumeration Date	:	06/17/2021
Last Update Date	:	06/17/2021

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Directions to “ MARIA V CARRASQUILLO ” Practice Location

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