Provider Demographics
NPI:1225173305
Name:GARCIA, NORA (LCDA)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LCDA
Other - Prefix:
Other - First Name:NORIMAR
Other - Middle Name:
Other - Last Name:VEGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 622
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-2734
Mailing Address - Country:US
Mailing Address - Phone:787-846-2630
Mailing Address - Fax:787-846-9206
Practice Address - Street 1:24 CALLE GEORGETTI
Practice Address - Street 2:SUITE 1
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-2734
Practice Address - Country:US
Practice Address - Phone:787-846-2630
Practice Address - Fax:787-846-9206
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F 0209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist