Provider Demographics
NPI:1750029898
Name:DIAZ FERREIRA, YAMILETTE MARVILLA (BS, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:YAMILETTE
Middle Name:MARVILLA
Last Name:DIAZ FERREIRA
Suffix:
Gender:F
Credentials:BS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 493 KM 6.6 BO MIRAFLORES
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-544-6486
Mailing Address - Fax:787-544-6894
Practice Address - Street 1:CARR 493 KM 6.6 BO MIRAFLORES
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-544-6486
Practice Address - Fax:787-544-6894
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7032183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7032OtherPHARMACIST LICENSE