Mariette Christie Cruz Soto, PHARMD

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Juncos, PR

NPI 1750869160 · NPPES record last updated Jul 30, 2018

Key facts

NPI
1750869160
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
6382 (PR)
Practice address
70 Calle Teodomiro Delfaus
Juncos, PR 00777
Phone
(787) 734-2186
Fax
(787) 734-2186
NPI assigned
Jul 30, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
6382PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Virgilio Cruz Rivera Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 6382 PR Yes

Addresses

Primary practice location

70 Calle Teodomiro Delfaus
Juncos, PR 00777

Mailing address

PO Box 1770
Juncos, PR 00777-1770
Phone (787) 734-2186

Other identifiers

IdentifierTypeStateIssuer
6382OtherPRPHARMACIST LICENSE

Other providers in Juncos, PR

All providers in Juncos, PR · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Puerto Rico

Sources for this page

Verify at the official NPI Registry.