Provider Demographics
NPI:1922205533
Name:VILLALOBO, WALESKA M (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MISS
First Name:WALESKA
Middle Name:M
Last Name:VILLALOBO
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 CALLE JARANDILLA
Mailing Address - Street 2:EMBALSE SAN JOSE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923-1704
Mailing Address - Country:US
Mailing Address - Phone:787-638-7354
Mailing Address - Fax:
Practice Address - Street 1:900 CALLE CERRA
Practice Address - Street 2:PDA. 15 SANTURCE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-5104
Practice Address - Country:US
Practice Address - Phone:787-977-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4013183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician