Provider Demographics
NPI:1841403086
Name:VARGAS-ORTIZ, SANDRA C (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:C
Last Name:VARGAS-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 1:1000 AVE JESUS T PINERO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-1819
Mailing Address - Country:US
Mailing Address - Phone:787-782-6129
Mailing Address - Fax:787-749-9077
Practice Address - Street 1:1000 AVE JESUS T PINERO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-1819
Practice Address - Country:US
Practice Address - Phone:787-782-6129
Practice Address - Fax:787-749-9077
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist