Provider Demographics
NPI:1629518717
Name:SOSA PIERNES, GABRIELA MARIA
Entity Type:Individual
Prefix:MISS
First Name:GABRIELA
Middle Name:MARIA
Last Name:SOSA PIERNES
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 1:200 CARR 181
Mailing Address - Street 2:KMART PHARMACY #4494
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-3600
Mailing Address - Country:US
Mailing Address - Phone:787-479-6007
Mailing Address - Fax:
Practice Address - Street 1:200 CARR 181
Practice Address - Street 2:KMART PHARMACY #4494
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-3600
Practice Address - Country:US
Practice Address - Phone:787-479-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6439183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist