Individual
MISS MARIELY DIAZ VARGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPH.T
Contact information
Practice address
CARR 149 KM 57.4 BO TIERRA SANTA, VILLALBA, PR 00766
(787) 847-9393
(787) 847-9292
Mailing address
URB JAIME L DREW, 104 AVE D, PONCE, PR 00730
(787) 847-9393
(787) 847-9292
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
4119
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4119
LICENSE
PR
Enumeration date
06/18/2019
Last updated
06/18/2019
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