Individual
ELSIE ANGELIC DIAZ BAEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1185 AVE 65 INFANTERIA, SAN JUAN, PR 00924-3403
(787) 999-7203
Mailing address
CC9 CALLE YUNQUESITO, URB MANSIONES DE CAROLINA, CAROLINA, PR 00987
(787) 517-2363
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6606
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6303
IMMUNIZATION LICENCE
PR
Enumeration date
03/14/2019
Last updated
03/14/2019
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