Provider Demographics
NPI:1255464103
Name:FARMACIA CDT DR. CAPARROS, INC
Entity Type:Organization
Organization Name:FARMACIA CDT DR. CAPARROS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-894-2288
Mailing Address - Street 1:CALLE BETANCES #2
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PA
Mailing Address - Zip Code:00641
Mailing Address - Country:US
Mailing Address - Phone:787-894-2288
Mailing Address - Fax:787-894-5731
Practice Address - Street 1:ESQUINA CALLE ANTONOIO BARCELO
Practice Address - Street 2:AVENIDA MORELL
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641
Practice Address - Country:US
Practice Address - Phone:787-814-1129
Practice Address - Fax:787-894-5731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-1499333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4020385OtherNABP