Provider Demographics
NPI:1619208964
Name:PEDRO, ELSA M (PHARM D, BCPS, BCOP)
Entity Type:Individual
Prefix:DR
First Name:ELSA
Middle Name:M
Last Name:PEDRO
Suffix:
Gender:F
Credentials:PHARM D, BCPS, BCOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 365067
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-5067
Mailing Address - Country:US
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:787-754-6995
Practice Address - Street 1:ESCUELA DE FARMACIA
Practice Address - Street 2:RECINTO DE CIENCIAS MEDICAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:787-754-6995
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004875183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist