Provider Demographics
NPI:1083750616
Name:CRESPO, MAYRA A (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MRS
First Name:MAYRA
Middle Name:A
Last Name:CRESPO
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BO BATEY COLUMBIA
Mailing Address - Street 2:APARTADO 26
Mailing Address - City:MAUNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00707
Mailing Address - Country:US
Mailing Address - Phone:787-224-7648
Mailing Address - Fax:787-893-2577
Practice Address - Street 1:CRISTOBAL COLON #25
Practice Address - Street 2:FARMACIA WILMET
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767
Practice Address - Country:US
Practice Address - Phone:787-893-1210
Practice Address - Fax:787-893-2577
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4581183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician