Individual
DR. IVONNE M SANTOS DEJESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
FARMACIA CARRAIZO, CARR 844 KM. 5 HM 6, TRUJILLO ALTO, PR 00928
(787) 760-2650
(787) 760-2650
Mailing address
SAN PATRICIO AVE, .SAN PATRICIO APARTMENTS # 1510, GUAYNABO, PR 00968
(787) 596-8383
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
#15614
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#15614
LOUISIANA STATE LICENCE #
LA
01
—
004920
P.R. STATE LICENCE NUMBER
PR
Enumeration date
12/13/2006
Last updated
07/08/2007
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