Tatiana Ivelisse Carraquillo Rosa, CPTH

Individual provider Active NPI Pharmacy Technician · Juncos, PR

NPI 1114488749 · NPPES record last updated Mar 27, 2019

Key facts

NPI
1114488749
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacy Technician 183700000X
License
12056 (PR)
Practice address
Bo Ceiba Norte
Carr 31 KM 24.5
Juncos, PR 00777
Phone
(787) 705-2239
Fax
(888) 580-6779
NPI assigned
Mar 27, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
12056PRMDObstetrics & Gynecology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 12056 PR Yes

Addresses

Primary practice location

Bo Ceiba Norte
Carr 31 KM 24.5
Juncos, PR 00777

Mailing address

109 Calle Jose Tous Soto
San Lorenzo, PR 00754
Phone (787) 388-6209

Other identifiers

IdentifierTypeStateIssuer
6564767OtherPRDRIVER'LICENCE

Other providers in Juncos, PR

All providers in Juncos, PR · Pharmacy Technician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.