Individual
MS. IRMA DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSPH
Contact information
Practice address
CARR. NO. 2 KM. 26.2, BO. ESPINOSA, DORADO, PR 00664-0000
(787) 882-2700
Mailing address
PO BOX 780, AGUADILLA, PR 00605-0780
(787) 882-2700
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
4909
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4909
STATE LICENSE
PR
Enumeration date
02/08/2012
Last updated
01/15/2020
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