Provider Demographics
NPI:1376601633
Name:HERNANDEZ-PIMENTEL, BRICEIDA (RPH)
Entity Type:Individual
Prefix:
First Name:BRICEIDA
Middle Name:
Last Name:HERNANDEZ-PIMENTEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 CAMINO DEL MONTE
Mailing Address - Street 2:MIRADERO DE HUMACAO
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-9667
Mailing Address - Country:US
Mailing Address - Phone:787-225-9958
Mailing Address - Fax:
Practice Address - Street 1:160 CAMINO DEL MONTE
Practice Address - Street 2:MIRADERO DE HUMACAO
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-9667
Practice Address - Country:US
Practice Address - Phone:787-893-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist