Provider Demographics
NPI:1649394644
Name:PIZARRO, JOSUE
Entity Type:Individual
Prefix:
First Name:JOSUE
Middle Name:
Last Name:PIZARRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 AVE ANDALUCIA
Mailing Address - Street 2:
Mailing Address - City:PUERTO NUEVO
Mailing Address - State:PR
Mailing Address - Zip Code:00920-4103
Mailing Address - Country:US
Mailing Address - Phone:787-667-6611
Mailing Address - Fax:
Practice Address - Street 1:362 AVE ANDALUCIA
Practice Address - Street 2:
Practice Address - City:PUERTO NUEVO
Practice Address - State:PR
Practice Address - Zip Code:00920-4103
Practice Address - Country:US
Practice Address - Phone:787-667-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-17
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist