Provider Demographics
NPI:1518374420
Name:GARCIA, MARTHA RUTH
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:RUTH
Last Name:GARCIA
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:CALLE MANATI # 55
Mailing Address - Street 2:HATO REY
Mailing Address - City:SAN JUAN
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00917
Mailing Address - Country:UM
Mailing Address - Phone:787-764-3520
Mailing Address - Fax:787-764-4011
Practice Address - Street 1:55 CALLE MANATI
Practice Address - Street 2:HATO REY
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-4419
Practice Address - Country:US
Practice Address - Phone:787-764-3520
Practice Address - Fax:787-764-4011
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1400183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician