Individual
IVELISSE JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
RES. JOSE DE DIEGO, E2 APT17, AGUADILLA, PR 00603
(787) 426-5500
Mailing address
PO BOX 4393, AGUADILLA, PR 00605-4393
(787) 426-5500
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
6440
PR
Other
Enumeration date
03/06/2012
Last updated
03/06/2012
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