Provider Demographics
NPI:1346729910
Name:FLORES BENITEZ, STEPHANIE (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:FLORES BENITEZ
Suffix:
Gender:F
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 1:105B CALLE AMOR
Mailing Address - Street 2:VILLA ESPERANZA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:939-417-7515
Mailing Address - Fax:
Practice Address - Street 1:DEL RIO SHOPPING CENTER VALLE TOLIMA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-653-8777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10871183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician