Provider Demographics
NPI:1922160241
Name:GONZALEZ FIGUEROA, MARIANA VICEORTA (AUXILIAR)
Entity Type:Individual
Prefix:MRS
First Name:MARIANA
Middle Name:VICEORTA
Last Name:GONZALEZ FIGUEROA
Suffix:
Gender:F
Credentials:AUXILIAR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB PATEOS REALES CALLE LA REINA #776
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-390-7398
Mailing Address - Fax:787-816-2156
Practice Address - Street 1:VICTOR ROJAS #2 ZONA INDUSTRIAL CARR 129
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-816-2156
Practice Address - Fax:787-816-2156
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4150183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician