Provider Demographics
NPI:1629445606
Name:GARCIA, GABRIEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CALLE 602 KM 0.6
Mailing Address - Street 2:FARMACIA LOS ANGELES
Mailing Address - City:ANGELES
Mailing Address - State:PR
Mailing Address - Zip Code:00611
Mailing Address - Country:US
Mailing Address - Phone:787-894-7535
Mailing Address - Fax:787-894-7535
Practice Address - Street 1:111 CALLE 602
Practice Address - Street 2:FARMACIA LOS ANGELES
Practice Address - City:ANGELES
Practice Address - State:PR
Practice Address - Zip Code:00611
Practice Address - Country:US
Practice Address - Phone:787-894-7535
Practice Address - Fax:787-894-7535
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5043183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist