Provider Demographics
NPI:1992007553
Name:VARGAS MAISONET, JOSEAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEAN
Middle Name:
Last Name:VARGAS MAISONET
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MIRABELLA VILLAGE CLUB
Mailing Address - Street 2:CALLE CUARZO #49
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:49 CALLE CUARZO
Practice Address - Street 2:MIRABELLA VILLAGE CLUB
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-4821
Practice Address - Country:US
Practice Address - Phone:787-313-1749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR005429183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist