Individual
MRS. IVELISSE MEDINA ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TECHNICIAN
Contact information
Practice address
5 CALLE CRISTOBAL COLON, YABUCOA, PR 00767-3328
(787) 893-2280
(787) 893-6738
Mailing address
HC 2 BOX 8874, YABUCOA, PR 00767-8874
(787) 893-1332
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
3276
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3276
TECHNICIAN LINCENSE
PR
Enumeration date
09/20/2006
Last updated
07/08/2007
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