Provider Demographics
NPI:1083251367
Name:GARCIA BARRETO, CARMEN MILAGROS
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:MILAGROS
Last Name:GARCIA BARRETO
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:PO BOX 439
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-0439
Mailing Address - Country:US
Mailing Address - Phone:787-904-6542
Mailing Address - Fax:787-623-8599
Practice Address - Street 1:BO ESPINOSA CARR 2 KM 30 H 1
Practice Address - Street 2:
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-883-2065
Practice Address - Fax:787-623-8599
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist