Provider Demographics
NPI:1679620157
Name:MAYMI, CARLOS ALBERTO (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:ALBERTO
Last Name:MAYMI
Suffix:
Gender:M
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:L18 CALLE SAN MARCOS
Mailing Address - Street 2:NOTRE DAME
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3912
Mailing Address - Country:US
Mailing Address - Phone:787-603-2659
Mailing Address - Fax:787-743-7764
Practice Address - Street 1:CARR 172 ESQ ASTURIAS
Practice Address - Street 2:3RA SECC VILLA DEL REY
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-746-5952
Practice Address - Fax:787-744-3397
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2162183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician