Individual
MR. JESUS GUILLERMO PORTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH.
Contact information
Practice address
67 MENDEZ VIGO E, MAYAGUEZ, PR 00680-4934
(787) 832-6645
Mailing address
67 MENDEZ VIGO E, MAYAGUEZ, PR 00680-4934
(787) 832-6645
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4335
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4335
PHARMACIST STATE LICENSE
PR
Enumeration date
10/26/2009
Last updated
10/26/2009
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