Provider Demographics
NPI:1609273796
Name:DIAZ, MILAGROS (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:MILAGROS
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2758 CALLE TOLEDO
Mailing Address - Street 2:VILLA DEL CARMEN
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2235
Mailing Address - Country:US
Mailing Address - Phone:787-906-5778
Mailing Address - Fax:
Practice Address - Street 1:2758 CALLE TOLEDO
Practice Address - Street 2:VILLA DEL CARMEN
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2235
Practice Address - Country:US
Practice Address - Phone:787-906-5778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6326183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician