Provider Demographics
NPI:1891080271
Name:FEBO, GLORIA M (RPH)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:M
Last Name:FEBO
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:AVE BALDORIOTY DE CASTRO WALGREENS 12663
Mailing Address - Street 2:NORTE SHOPPING CENTER
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00979-0000
Mailing Address - Country:US
Mailing Address - Phone:787-727-7111
Mailing Address - Fax:787-727-7230
Practice Address - Street 1:CENTRO COMERCIAL NORTE SHOPPING WAGREENS
Practice Address - Street 2:NORTE SHOPPING CENTER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00979-0000
Practice Address - Country:US
Practice Address - Phone:787-727-7111
Practice Address - Fax:787-727-7230
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2006183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist