Provider Demographics
NPI:1659466506
Name:FELICIANO, YOLANDA (PHARM)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:FELICIANO
Suffix:
Gender:F
Credentials:PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 18-O-43 BELLA VISTA
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-6106
Mailing Address - Country:US
Mailing Address - Phone:787-799-7091
Mailing Address - Fax:787-799-7091
Practice Address - Street 1:O43 CALLE 18
Practice Address - Street 2:URB BELLA VISTA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-6106
Practice Address - Country:US
Practice Address - Phone:787-799-7091
Practice Address - Fax:787-799-7091
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3630183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist