Provider Demographics
NPI:1083005847
Name:MACHUCA ROSARIO, MARIA (BS)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MACHUCA ROSARIO
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 PRADERAS DE NAVARRO
Mailing Address - Street 2:CALLE TOPACIO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-960-2388
Mailing Address - Fax:
Practice Address - Street 1:357 CALLE TOPACIO
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-9053
Practice Address - Country:US
Practice Address - Phone:787-960-2388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5188183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist