Provider Demographics
NPI:1740422450
Name:BONILLA-RAMOS, CARMEN (CPH TECH)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:BONILLA-RAMOS
Suffix:
Gender:F
Credentials:CPH TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 9 BLQ 5 #20
Mailing Address - Street 2:SABANA GARDEN
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983
Mailing Address - Country:US
Mailing Address - Phone:787-701-6021
Mailing Address - Fax:
Practice Address - Street 1:5-20 CALLE 9
Practice Address - Street 2:SABANA GARDEN
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-2916
Practice Address - Country:US
Practice Address - Phone:787-701-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR121439OtherC.PH.TECH