Provider Demographics
NPI:1972622793
Name:GARCIA, PEDRO (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PHARMACIST
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 1058
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-1058
Mailing Address - Country:US
Mailing Address - Phone:787-899-3341
Mailing Address - Fax:
Practice Address - Street 1:CARR 304 AVE LOS PESCADORES
Practice Address - Street 2:LA PARGUERA
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667
Practice Address - Country:US
Practice Address - Phone:787-899-8719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist