Provider Demographics
NPI:1114057239
Name:TOLEDO VEGA, LINNETTE
Entity Type:Individual
Prefix:
First Name:LINNETTE
Middle Name:
Last Name:TOLEDO VEGA
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:HC-10 BOX 7765
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-7765
Mailing Address - Country:US
Mailing Address - Phone:787-267-5840
Mailing Address - Fax:787-267-3045
Practice Address - Street 1:CALLE 65 INFANTERIA A-1
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3060
Practice Address - Country:US
Practice Address - Phone:787-267-5840
Practice Address - Fax:787-267-3045
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist