Individual
MIRIAM LOPEZ LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
CORPORACION DEL FONDO DEL SEGURO DEL ESTADO, CARR #3 65TH INFANTERIA SECTOR COMUNIDAD ESCORIAL, CAROLINA, PR 00985
(787) 757-6850
Mailing address
BRISAS DE LOIZA, CALLE SAGITARIO #95, CANOVANAS, PUERTO RICO 00729
(787) 460-1970
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
001455
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1638270
DRIVERS LICENCE
PR
Enumeration date
04/23/2012
Last updated
04/23/2012
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