Provider Demographics
NPI:1619981537
Name:DE LEON, GLORIA J (RPH)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:J
Last Name:DE LEON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND. MANS. GDNS. HILLS
Mailing Address - Street 2:11B TORRE NORTE
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-783-0896
Mailing Address - Fax:787-651-4313
Practice Address - Street 1:COND. MANS. GDNS. HILLS
Practice Address - Street 2:11 B TORRE NORTE
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-783-0896
Practice Address - Fax:787-651-4313
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1761183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist