Provider Demographics
NPI:1376915835
Name:VIRELLA, GILMARIS
Entity Type:Individual
Prefix:
First Name:GILMARIS
Middle Name:
Last Name:VIRELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:GILMARIS
Other - Middle Name:
Other - Last Name:VIRELLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:COMERIO
Mailing Address - State:PR
Mailing Address - Zip Code:00782-0430
Mailing Address - Country:US
Mailing Address - Phone:787-970-8107
Mailing Address - Fax:
Practice Address - Street 1:HC 2 BOX 7240
Practice Address - Street 2:
Practice Address - City:COMERIO
Practice Address - State:PR
Practice Address - Zip Code:00782-9627
Practice Address - Country:US
Practice Address - Phone:787-970-8107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist