Provider Demographics
NPI:1235222308
Name:MASA, MILAGROS (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MRS
First Name:MILAGROS
Middle Name:
Last Name:MASA
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:MRS
Other - First Name:MILAGROS
Other - Middle Name:
Other - Last Name:MASA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMACY TECHNICIAN
Mailing Address - Street 1:2 CALLE MUNOZ RIVERA
Mailing Address - Street 2:PMB 292 PO BOX 4952
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-2603
Mailing Address - Country:US
Mailing Address - Phone:787-248-2405
Mailing Address - Fax:
Practice Address - Street 1:2 AVE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-248-2405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004475247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR004475OtherPHARMACY TECHNICIAN