Provider Demographics
NPI:1225256340
Name:OQUENDO, ABIGAIL (BS)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:OQUENDO
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VIA PIEDRAS RE-8 RIO CRISTAL ENCANTADA
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00976
Mailing Address - Country:UM
Mailing Address - Phone:787-400-3595
Mailing Address - Fax:
Practice Address - Street 1:CARR 187 KM 7.0 MEDIANIA ALTA
Practice Address - Street 2:
Practice Address - City:LOIZA
Practice Address - State:PR
Practice Address - Zip Code:00772
Practice Address - Country:US
Practice Address - Phone:787-876-1927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004329183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist