Provider Demographics
NPI:1891423067
Name:DIAZ BULA, ADRIANA BEATRIZ (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:ADRIANA
Middle Name:BEATRIZ
Last Name:DIAZ BULA
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:PO BOX 3646
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-3646
Mailing Address - Country:US
Mailing Address - Phone:787-448-0129
Mailing Address - Fax:
Practice Address - Street 1:4210 CARR 693
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4802
Practice Address - Country:US
Practice Address - Phone:787-278-5811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2437183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2437OtherPUERTO RICO BOARD OF PHARMACY