Provider Demographics
NPI:1003353608
Name:CANDELARIO GONZALEZ, SINDY
Entity Type:Individual
Prefix:
First Name:SINDY
Middle Name:
Last Name:CANDELARIO GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 PASEO DEL VETERANO
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2001
Mailing Address - Country:US
Mailing Address - Phone:787-641-7582
Mailing Address - Fax:787-651-4317
Practice Address - Street 1:1010 PASEO DEL VETERANO
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2001
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:787-651-4317
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR41921835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist