Provider Demographics
NPI:1821030941
Name:ROSARIO VELAZQUEZ, CORP
Entity Type:Organization
Organization Name:ROSARIO VELAZQUEZ, CORP
Other - Org Name:SUPER FARMACIA VISALMARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-650-3301
Mailing Address - Street 1:HC 2 BOX 5656
Mailing Address - Street 2:
Mailing Address - City:BAJADERO
Mailing Address - State:PR
Mailing Address - Zip Code:00616-9864
Mailing Address - Country:US
Mailing Address - Phone:787-650-3301
Mailing Address - Fax:787-650-3302
Practice Address - Street 1:CARRETERA 2 RAMAL 638
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-650-3301
Practice Address - Fax:787-650-3302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR40231533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy