Provider Demographics
NPI:1275767444
Name:CABAN, ERNESTO (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MR
First Name:ERNESTO
Middle Name:
Last Name:CABAN
Suffix:
Gender:M
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CALLE 22 DE JUNIO
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-4241
Mailing Address - Country:US
Mailing Address - Phone:787-404-8920
Mailing Address - Fax:
Practice Address - Street 1:CARR #2 KM 109.9
Practice Address - Street 2:BO.GALATEO BAJO
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-872-5943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3704183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician