Provider Demographics
NPI:1578790085
Name:MENDEZ SEGARRA, CYNTHIA (PHARM TEC)
Entity Type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:
Last Name:MENDEZ SEGARRA
Suffix:
Gender:F
Credentials:PHARM TEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 32082
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-0685
Mailing Address - Country:US
Mailing Address - Phone:787-630-9277
Mailing Address - Fax:
Practice Address - Street 1:CALLE 2 URB. VENTURINI CASA D12
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-7516
Practice Address - Country:US
Practice Address - Phone:787-630-9277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5740183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician