Provider Demographics
NPI:1518011949
Name:FARMACIA LIDELIZ
Entity Type:Organization
Organization Name:FARMACIA LIDELIZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLARIBEL
Authorized Official - Middle Name:COLON
Authorized Official - Last Name:SIFONTE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-862-5279
Mailing Address - Street 1:43 CALLE PRINCIPAL
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-3051
Mailing Address - Country:US
Mailing Address - Phone:787-862-5279
Mailing Address - Fax:787-862-5279
Practice Address - Street 1:43 CALLE PRINCIPAL
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687-3051
Practice Address - Country:US
Practice Address - Phone:787-862-5279
Practice Address - Fax:787-862-5279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-2297333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy