Provider Demographics
NPI:1174656672
Name:RESTO-TORRES, GLORIA (RPH)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:RESTO-TORRES
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 1:99-24 CALLE 93
Mailing Address - Street 2:VILLA CAROLINA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-4158
Mailing Address - Country:US
Mailing Address - Phone:787-615-4020
Mailing Address - Fax:
Practice Address - Street 1:9615 AVE LOS ROMEROS
Practice Address - Street 2:SUITE 515
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-7036
Practice Address - Country:US
Practice Address - Phone:787-287-2314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3245183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3245OtherPR PHARMACIST LICENSE NUM