Provider Demographics
NPI:1013201193
Name:ROBLES VINCENTY, KATHERINE M (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:M
Last Name:ROBLES VINCENTY
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1479 AVE ASHFORD APT C14
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-6402
Mailing Address - Country:US
Mailing Address - Phone:787-368-8725
Mailing Address - Fax:
Practice Address - Street 1:1963 LOIZA STREET
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911
Practice Address - Country:US
Practice Address - Phone:787-728-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5510183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist