Provider Demographics
NPI:1508905969
Name:RODRIGUEZ, VILMA L (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MRS
First Name:VILMA
Middle Name:L
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 02 BOX 2416
Mailing Address - Street 2:
Mailing Address - City:MAUNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00707-9568
Mailing Address - Country:US
Mailing Address - Phone:787-861-3474
Mailing Address - Fax:787-861-1056
Practice Address - Street 1:CALLE BARCELO #17
Practice Address - Street 2:TU FARMACIA FAMILIAR
Practice Address - City:MAUNABO
Practice Address - State:PR
Practice Address - Zip Code:00707
Practice Address - Country:US
Practice Address - Phone:787-861-4855
Practice Address - Fax:787-861-1056
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3952183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
3952OtherLIC PH TEC