Provider Demographics
NPI:1588028872
Name:GINES, IBIS C (PHARMACIST)
Entity type:Individual
Prefix:
First Name:IBIS
Middle Name:C
Last Name:GINES
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A8 CALLE VILLA DEL PARQUE
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3719
Mailing Address - Country:US
Mailing Address - Phone:787-501-2258
Mailing Address - Fax:
Practice Address - Street 1:A8 CALLE A VILLA DEL PARQUE
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3719
Practice Address - Country:US
Practice Address - Phone:787-501-2258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4462183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist