1043504558 NPI number — MRS. MARIA DEL C. GUISAO PHARMACIST

Table of content: MRS. MARIA DEL C. GUISAO PHARMACIST (NPI 1043504558)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043504558 NPI number — MRS. MARIA DEL C. GUISAO PHARMACIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUISAO
Provider First Name:
MARIA
Provider Middle Name:
DEL C.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHARMACIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PENA
Provider Other First Name:
IDALINES
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMACIST
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1043504558
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB, OLYMPIC COURT C20 CALLE TEBAS
Provider Second Line Business Mailing Address:
CALLE TEBAS #198
Provider Business Mailing Address City Name:
LAS PIEDRAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00771
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-285-0810
Provider Business Mailing Address Fax Number:
787-285-2664

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
198 CALLE TEBAS
Provider Second Line Business Practice Location Address:
URB. OLYMPIC COURT C20
Provider Business Practice Location Address City Name:
LAS PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00771-9017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-285-0810
Provider Business Practice Location Address Fax Number:
787-285-0810
Provider Enumeration Date:
06/01/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  3969 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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