Provider Demographics
NPI:1790995215
Name:MADRIZ, LUZ M (RPH)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:M
Last Name:MADRIZ
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 1:70 COND BALCONES DE MONTE REAL
Mailing Address - Street 2:APT.6102
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-2292
Mailing Address - Country:US
Mailing Address - Phone:787-402-9373
Mailing Address - Fax:787-256-0172
Practice Address - Street 1:70 COND BALCONES DE MONTE REAL
Practice Address - Street 2:APT.6102
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-2292
Practice Address - Country:US
Practice Address - Phone:787-402-9373
Practice Address - Fax:787-256-0172
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist