Individual
MRS. JESSICA IVELLISE CORREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPHTECH
Contact information
Practice address
CARR 3 KM 28.8, RIO GRANDE, PR 00745
(787) 887-2602
(787) 809-8398
Mailing address
28 CALLE SOLEDAD, RIO GRANDE, PR 00745-2934
(787) 887-2602
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
4573
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4573
PHARMACY TECH. LICENSE
PR
Enumeration date
09/15/2006
Last updated
07/08/2007
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