Provider Demographics
NPI:1639377237
Name:FONTANEZ, YOLYNETTE RIVERA
Entity Type:Individual
Prefix:
First Name:YOLYNETTE
Middle Name:RIVERA
Last Name:FONTANEZ
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 1:4682 CALLE PARQUE S
Mailing Address - Street 2:PARCELA 290
Mailing Address - City:SABANA SECA
Mailing Address - State:PR
Mailing Address - Zip Code:00952-4284
Mailing Address - Country:US
Mailing Address - Phone:787-795-0337
Mailing Address - Fax:
Practice Address - Street 1:4682 CALLE PARQUE SUR
Practice Address - Street 2:PARCELA 290
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00952
Practice Address - Country:US
Practice Address - Phone:787-795-0337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician