Provider Demographics
NPI:1942597687
Name:FIGUEROA-DOMINGUEZ, NELSON (RPH)
Entity Type:Individual
Prefix:MR
First Name:NELSON
Middle Name:
Last Name:FIGUEROA-DOMINGUEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 TAMPA ST.
Mailing Address - Street 2:SAN GERARDO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-3433
Mailing Address - Country:US
Mailing Address - Phone:787-754-6404
Mailing Address - Fax:
Practice Address - Street 1:315 TAMPA ST.
Practice Address - Street 2:SAN GERARDO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-3433
Practice Address - Country:US
Practice Address - Phone:787-754-6404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1798OtherREGISTERED PHARMACIST, PUERTO RICO LICENSE NUMBER