Provider Demographics
NPI:1386182889
Name:DEL MORAL BALLESTEROS, ERIKA MARIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:MARIA
Last Name:DEL MORAL BALLESTEROS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 INFANTA
Mailing Address - Street 2:URB VALLE REAL
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-430-9055
Mailing Address - Fax:
Practice Address - Street 1:1822 INFANTA
Practice Address - Street 2:URB VALLE REAL
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-430-9055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist