Provider Demographics
NPI:1689746042
Name:VICENTE, LYMARI (RPH)
Entity Type:Individual
Prefix:
First Name:LYMARI
Middle Name:
Last Name:VICENTE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1777
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-1777
Mailing Address - Country:US
Mailing Address - Phone:787-739-1157
Mailing Address - Fax:787-739-3195
Practice Address - Street 1:CAMINO MIRAMELINDAS # 400
Practice Address - Street 2:URB SABANERA
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-714-0410
Practice Address - Fax:787-714-0410
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist