Provider Demographics
NPI:1609637503
Name:MARIANO, MA. HASMINE JOY ZAPANTA
Entity Type:Individual
Prefix:
First Name:MA. HASMINE JOY
Middle Name:ZAPANTA
Last Name:MARIANO
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 1:143 PLUMERIA ST
Mailing Address - Street 2:
Mailing Address - City:DEDEDO
Mailing Address - State:GU
Mailing Address - Zip Code:96929-5928
Mailing Address - Country:US
Mailing Address - Phone:671-483-8810
Mailing Address - Fax:
Practice Address - Street 1:655 HARMON LOOP RD STE 108
Practice Address - Street 2:
Practice Address - City:DEDEDO
Practice Address - State:GU
Practice Address - Zip Code:96929-6544
Practice Address - Country:US
Practice Address - Phone:671-633-3684
Practice Address - Fax:671-633-3680
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUPH0574183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist