Provider Demographics
NPI:1508444506
Name:ESTRELLA-OSORIO, YAJAIRA MARY
Entity Type:Individual
Prefix:
First Name:YAJAIRA
Middle Name:MARY
Last Name:ESTRELLA-OSORIO
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 1:2550 AVE DE DIEGO
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-4800
Mailing Address - Country:US
Mailing Address - Phone:787-762-8412
Mailing Address - Fax:787-762-8479
Practice Address - Street 1:2550 AVE DE DIEGO
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-4800
Practice Address - Country:US
Practice Address - Phone:787-762-8412
Practice Address - Fax:787-762-8479
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10445183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician