Provider Demographics
NPI:1073590873
Name:FARMACIA GABRIELA
Entity Type:Organization
Organization Name:FARMACIA GABRIELA
Other - Org Name:MEGA FARMACIA GABRIELA
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-844-4958
Mailing Address - Street 1:PO BOX 800670
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-0670
Mailing Address - Country:US
Mailing Address - Phone:787-290-1963
Mailing Address - Fax:787-290-1953
Practice Address - Street 1:CARRETERA 132 KM 22.1
Practice Address - Street 2:BO. RIO CANAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731
Practice Address - Country:US
Practice Address - Phone:787-290-1953
Practice Address - Fax:787-290-1953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11-F-19323336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4023343OtherNCPDP