Provider Demographics
NPI:1568517373
Name:SEGUINOT, WIDNELIA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:WIDNELIA
Middle Name:
Last Name:SEGUINOT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4006 COND TORRES DEL ESCORIAL
Mailing Address - Street 2:SUITE 3703
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-5174
Mailing Address - Country:US
Mailing Address - Phone:787-449-5410
Mailing Address - Fax:
Practice Address - Street 1:4006 COND TORRES DEL ESCORIAL
Practice Address - Street 2:SUITE 3703
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-5174
Practice Address - Country:US
Practice Address - Phone:787-449-5410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist