Provider Demographics
NPI:1114083334
Name:EMMANUELLI, ANGELINA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ANGELINA
Middle Name:
Last Name:EMMANUELLI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:B32 CALLE 4
Mailing Address - Street 2:ESTANCIAS DE SAN FERNANDO
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-5213
Mailing Address - Country:US
Mailing Address - Phone:787-757-1599
Mailing Address - Fax:787-757-2504
Practice Address - Street 1:B32 CALLE 4
Practice Address - Street 2:ESTANCIAS DE SAN FERNANDO
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-5213
Practice Address - Country:US
Practice Address - Phone:787-757-1599
Practice Address - Fax:787-757-2504
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3591OtherPHARMACIST LICENSE