Provider Demographics
NPI:1578151965
Name:GARCIA, ROSANIE
Entity Type:Individual
Prefix:
First Name:ROSANIE
Middle Name:
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 1:905 CALLE MUNOZ RIVERA
Mailing Address - Street 2:
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624-1401
Mailing Address - Country:US
Mailing Address - Phone:787-836-1058
Mailing Address - Fax:787-836-1058
Practice Address - Street 1:905 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624-1401
Practice Address - Country:US
Practice Address - Phone:787-836-1058
Practice Address - Fax:787-836-1058
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-02
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5458183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist