Provider Demographics
NPI:1518178490
Name:CASTELLANO RIVERA, KARLA
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:CASTELLANO RIVERA
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:HC-05 BOX 10126
Mailing Address - Street 2:CARR. 159 KM 8.4 BO. PADILLA
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783
Mailing Address - Country:US
Mailing Address - Phone:787-597-6530
Mailing Address - Fax:
Practice Address - Street 1:FARMACIA KARIAN
Practice Address - Street 2:CARR 159 KM 8.4 BO. PADILLA
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783
Practice Address - Country:US
Practice Address - Phone:787-597-6530
Practice Address - Fax:
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
PR5936183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician