Provider Demographics
NPI:1922355882
Name:CARTAGENA, JUAN A
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:A
Last Name:CARTAGENA
Suffix:
Gender:M
Credentials:
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 7891
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7891
Mailing Address - Country:US
Mailing Address - Phone:787-671-9768
Mailing Address - Fax:787-745-5237
Practice Address - Street 1:CARR 172 ESQ ASTURIAS
Practice Address - Street 2:3RA SECC VILLA DEL REY
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726-5986
Practice Address - Country:US
Practice Address - Phone:787-746-5952
Practice Address - Fax:787-744-3397
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist