Provider Demographics
NPI:1285193813
Name:DE LA CRUZ ARRENDEL, VANESSA IDELIZA (PHARMACIST TECH)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:IDELIZA
Last Name:DE LA CRUZ ARRENDEL
Suffix:
Gender:F
Credentials:PHARMACIST TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 CALLE NEPTUNO
Mailing Address - Street 2:URB COUNTRY VIEW
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-4373
Mailing Address - Country:US
Mailing Address - Phone:787-256-6029
Mailing Address - Fax:787-400-8686
Practice Address - Street 1:CALLE 1 BLOQUE 1
Practice Address - Street 2:URB VILLAS DE LOIZA
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-876-3500
Practice Address - Fax:787-400-8686
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
9702183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician