Provider Demographics
NPI:1407123151
Name:ARAGONES, ELLIS SHAMYR (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:ELLIS
Middle Name:SHAMYR
Last Name:ARAGONES
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:ELLIS
Other - Middle Name:
Other - Last Name:ARAGONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACYST
Mailing Address - Street 1:CALLE TORCAZ URBANIZACION HACIENDA PALOMA
Mailing Address - Street 2:#81
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773-0773
Mailing Address - Country:US
Mailing Address - Phone:787-435-9318
Mailing Address - Fax:787-860-1614
Practice Address - Street 1:CALLE MARGINAL
Practice Address - Street 2:4203
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-0738
Practice Address - Country:US
Practice Address - Phone:787-860-1603
Practice Address - Fax:787-860-1614
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist