Provider Demographics
NPI:1083740419
Name:BARROSO, KATTY B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATTY
Middle Name:B
Last Name:BARROSO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 CALLE TULIPAN
Mailing Address - Street 2:URB. VICTORIA
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-4722
Mailing Address - Country:US
Mailing Address - Phone:787-450-8725
Mailing Address - Fax:
Practice Address - Street 1:CARR 420 KM 0.5
Practice Address - Street 2:SUPER FARMACIA FAMILIAR BO. VOLADORAS
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-877-7322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4557183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist