Provider Demographics
NPI:1437573979
Name:OQUENDO, FARRAH
Entity Type:Individual
Prefix:MRS
First Name:FARRAH
Middle Name:
Last Name:OQUENDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RES. MANUEL A. PEREZ
Mailing Address - Street 2:EDIF. F-5 APT. 51
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923
Mailing Address - Country:US
Mailing Address - Phone:787-388-6333
Mailing Address - Fax:787-763-2480
Practice Address - Street 1:RES. MANUEL A. PEREZ
Practice Address - Street 2:EDIF. F-5 APT. 51
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923
Practice Address - Country:US
Practice Address - Phone:787-388-6333
Practice Address - Fax:787-763-2480
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR35487164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse