Provider Demographics
NPI:1568950327
Name:FLORES, MARIANGELIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:MARIANGELIE
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:MARIANGELIE
Other - Middle Name:
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:839 CALLE ANASCO APT 623
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00925-2454
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:FARMACIAS PLAZA CENTRO COMERCIAL PLAZA DEL SOL
Practice Address - Street 2:OP4 AVE WEST MAIN URB SIERRA BAYAMON
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-920-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6357183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist