Provider Demographics
NPI:1467846618
Name:FIGUEROA, IVAN J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:IVAN
Middle Name:J
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 AVE ARBOLOTE
Mailing Address - Street 2:APT 135
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5501
Mailing Address - Country:US
Mailing Address - Phone:787-318-3563
Mailing Address - Fax:
Practice Address - Street 1:12 AVE ARBOLOTE
Practice Address - Street 2:APT 135
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5501
Practice Address - Country:US
Practice Address - Phone:787-318-3563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4584183500000X
FLPS33819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR885662OtherNATIONAL ASSOCIATION OF BOARDS OF PHARMACY (NABP)