Provider Demographics
NPI:1760525778
Name:ROSARIO-ORTIZ, EVELYN (RPH)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:ROSARIO-ORTIZ
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:V40 CALLE 24
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-5106
Mailing Address - Country:US
Mailing Address - Phone:787-888-1700
Mailing Address - Fax:787-887-7226
Practice Address - Street 1:41 CALLE PIMENTEL
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-3060
Practice Address - Country:US
Practice Address - Phone:787-888-1700
Practice Address - Fax:787-887-7226
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist