Provider Demographics
NPI:1013556190
Name:FEBRES, MABEL JELITZA (RPH, MS, FACA)
Entity Type:Individual
Prefix:
First Name:MABEL
Middle Name:JELITZA
Last Name:FEBRES
Suffix:
Gender:F
Credentials:RPH, MS, FACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 SIERRA MORENA
Mailing Address - Street 2:PMB 560
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-708-1300
Mailing Address - Fax:787-708-1800
Practice Address - Street 1:AVE EMILIANO POL 489
Practice Address - Street 2:LAS CUMBRES
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-708-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR45993336C0003X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4027175OtherNABP