Provider Demographics
NPI:1629265533
Name:QUILES, NICOLE MARIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:QUILES
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13
Mailing Address - Street 2:1275 MONTECARLO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1275 CALLE 13
Practice Address - Street 2:MONTECARLO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-5236
Practice Address - Country:US
Practice Address - Phone:787-752-6678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5278183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist