Individual
MADELINE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TECHNICIAN PHARMACIS
Contact information
Practice address
CARR 462 KM 1.2, CAIMITAL ALTO, AGUADILLA, PR 00603
(787) 219-4473
Mailing address
HC 6 BOX 68059, AGUADILLA, PR 00603-9898
(787) 219-4473
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
5762
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4065933
DRIVER LIC
PR
01
—
5762
PHARMACYST TECHNICIN #
PR
Enumeration date
01/30/2017
Last updated
01/30/2017
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