Provider Demographics
NPI:1497966428
Name:FUENTES, LIMARY (AUX)
Entity Type:Individual
Prefix:MS
First Name:LIMARY
Middle Name:
Last Name:FUENTES
Suffix:
Gender:F
Credentials:AUX
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ROAD 156 KM 13.4 BO. PALO HINCADO
Mailing Address - Street 2:HC-03 BOX 7600
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794
Mailing Address - Country:US
Mailing Address - Phone:787-516-6943
Mailing Address - Fax:787-857-4280
Practice Address - Street 1:ROAD 156 KM 13.4 BO. PALO HINCADO
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794
Practice Address - Country:US
Practice Address - Phone:787-857-3980
Practice Address - Fax:787-857-4280
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2818183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician