Provider Demographics
NPI:1841757184
Name:NUNEZ VELLON, JACKIMARIE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:JACKIMARIE
Middle Name:
Last Name:NUNEZ VELLON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:L36 CALLE 13
Mailing Address - Street 2:URB EL CONQUISTADOR
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-647-5639
Mailing Address - Fax:
Practice Address - Street 1:L36 CALLE 13
Practice Address - Street 2:URB EL CONQUISTADOR
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-647-5639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006550183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist