Provider Demographics
NPI:1891835286
Name:CORSINO, YAMILETTE
Entity Type:Individual
Prefix:
First Name:YAMILETTE
Middle Name:
Last Name:CORSINO
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:E35 CALLE 3
Mailing Address - Street 2:JARDINES DE CANOVANAS
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-3300
Mailing Address - Country:US
Mailing Address - Phone:787-876-4993
Mailing Address - Fax:787-256-0172
Practice Address - Street 1:E35 CALLE 3
Practice Address - Street 2:JARDINES DE CANOVANAS
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-3300
Practice Address - Country:US
Practice Address - Phone:787-876-4993
Practice Address - Fax:787-256-0172
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4576183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician