| NPI | 1992386668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY E ACEVEDO-GONZALEZ Credentialing Specialist 787-980-6770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2021-06-16 |