Provider Demographics
NPI:1346829306
Name:GERARDINO, NORBERTO (PHARMD)
Entity Type:Individual
Prefix:
First Name:NORBERTO
Middle Name:
Last Name:GERARDINO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 DE DIEGO AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909-1739
Mailing Address - Country:US
Mailing Address - Phone:787-723-6868
Mailing Address - Fax:787-721-6475
Practice Address - Street 1:359 DE DIEGO AVE STE 101
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1739
Practice Address - Country:US
Practice Address - Phone:787-723-6868
Practice Address - Fax:787-721-6475
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004114183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist