Provider Demographics
NPI:1720001274
Name:RUBIO, BEVERLY ANNETTE (RPH)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:ANNETTE
Last Name:RUBIO
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:P5 CALLE 1
Mailing Address - Street 2:URB DOS RIOS
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4006
Mailing Address - Country:US
Mailing Address - Phone:787-501-4384
Mailing Address - Fax:787-784-6131
Practice Address - Street 1:CARR # 2 KM 7.1
Practice Address - Street 2:SANTA ROSA MALL LOCAL 24
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-786-6306
Practice Address - Fax:787-966-7652
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist