Provider Demographics
NPI:1972624492
Name:SANCHEZ, MARLINE
Entity Type:Individual
Prefix:MRS
First Name:MARLINE
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
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 102
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-0102
Mailing Address - Country:US
Mailing Address - Phone:787-384-5154
Mailing Address - Fax:787-847-3785
Practice Address - Street 1:31 CALLE MUNOZ RIVERA
Practice Address - Street 2:FARMACIA GONZALEZ
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766-2219
Practice Address - Country:US
Practice Address - Phone:787-384-5154
Practice Address - Fax:787-847-3785
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5799183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician