Provider Demographics
NPI:1093098485
Name:OLIVERAS, INDHIRA A (PHARMACY TECNICHIAN)
Entity Type:Individual
Prefix:MS
First Name:INDHIRA
Middle Name:A
Last Name:OLIVERAS
Suffix:
Gender:F
Credentials:PHARMACY TECNICHIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 AVE GENERAL RAMEY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:PR
Mailing Address - Zip Code:00690-1204
Mailing Address - Country:US
Mailing Address - Phone:787-890-3340
Mailing Address - Fax:
Practice Address - Street 1:1052 AVE GENERAL RAMEY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:PR
Practice Address - Zip Code:00690-1204
Practice Address - Country:US
Practice Address - Phone:787-890-3340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7722183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician