Provider Demographics
NPI:1659902187
Name:DUMONT, NATIVIDAD II (TECNICO FARMACIA)
Entity Type:Individual
Prefix:
First Name:NATIVIDAD
Middle Name:
Last Name:DUMONT
Suffix:II
Gender:F
Credentials:TECNICO FARMACIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BO. MARAVILLA ESTES CARR.124 K.M 0.4
Mailing Address - Street 2:
Mailing Address - City:LAS MARIAS
Mailing Address - State:PR
Mailing Address - Zip Code:00670
Mailing Address - Country:US
Mailing Address - Phone:787-246-3144
Mailing Address - Fax:787-280-4188
Practice Address - Street 1:BO. MARAVILLA ESTE, CARR. 124 K.M.0.4
Practice Address - Street 2:
Practice Address - City:LAS MARIAS
Practice Address - State:PR
Practice Address - Zip Code:00670
Practice Address - Country:US
Practice Address - Phone:787-896-1111
Practice Address - Fax:787-280-4188
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR005388183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician