Provider Demographics
NPI:1043504558
Name:GUISAO, MARIA DEL C (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DEL C
Last Name:GUISAO
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:MRS
Other - First Name:IDALINES
Other - Middle Name:
Other - Last Name:PENA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:URB, OLYMPIC COURT C20 CALLE TEBAS
Mailing Address - Street 2:CALLE TEBAS #198
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771
Mailing Address - Country:US
Mailing Address - Phone:787-285-0810
Mailing Address - Fax:787-285-2664
Practice Address - Street 1:198 CALLE TEBAS
Practice Address - Street 2:URB. OLYMPIC COURT C20
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-9017
Practice Address - Country:US
Practice Address - Phone:787-285-0810
Practice Address - Fax:787-285-0810
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3969183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist