Provider Demographics
NPI:1033479811
Name:DEL VALLE, DIANA SARAHID
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:SARAHID
Last Name:DEL VALLE
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:HOSPITAL INDUSTRIAL 365028
Mailing Address - Street 2:CENTRO MEDICO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-5028
Mailing Address - Country:US
Mailing Address - Phone:787-754-2525
Mailing Address - Fax:787-282-7426
Practice Address - Street 1:CARRETERA #22 CENTRO MEDICO DE PUERTO RICO
Practice Address - Street 2:BO. MONACILLOS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00922
Practice Address - Country:US
Practice Address - Phone:787-754-2525
Practice Address - Fax:787-282-7426
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7785183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician