Provider Demographics
NPI:1821123514
Name:SUAREZ CORNIER, FELICITA
Entity Type:Individual
Prefix:
First Name:FELICITA
Middle Name:
Last Name:SUAREZ CORNIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 196
Mailing Address - Street 2:CALL BOX 5004
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698
Mailing Address - Country:US
Mailing Address - Phone:787-835-4778
Mailing Address - Fax:
Practice Address - Street 1:CALLE BALDORIOTY #16
Practice Address - Street 2:FCIA MENAY
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-856-1111
Practice Address - Fax:787-856-1111
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004399183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician