Individual
TATIANA IVELISSE CARRAQUILLO ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPTH
Contact information
Practice address
BO CEIBA NORTE, CARR 31 KM 24.5, JUNCOS, PR 00777
(787) 705-2239
(888) 580-6779
Mailing address
109 CALLE JOSE TOUS SOTO, SAN LORENZO, PR 00754
(787) 388-6209
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
12056
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6564767
DRIVER'LICENCE
PR
Enumeration date
03/27/2019
Last updated
03/27/2019
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