Provider Demographics
NPI:1598976284
Name:VARGAS, LYMARI AMALIA
Entity Type:Individual
Prefix:
First Name:LYMARI
Middle Name:AMALIA
Last Name:VARGAS
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:URB. ANA MARIA
Mailing Address - Street 2:CALLE 4 E-40
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623
Mailing Address - Country:US
Mailing Address - Phone:787-502-6053
Mailing Address - Fax:
Practice Address - Street 1:CENTRO PROFESIONAL BORINQUEN
Practice Address - Street 2:CARR 102
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:787-851-1500
Practice Address - Fax:787-254-0230
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3641183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician