Provider Demographics
NPI:1013056522
Name:GARCIA, MARIE C (RPH)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:C
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 VALLADOLID PONCE DE LEON
Mailing Address - Street 2:URB. PONCE DE LEON
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-5164
Mailing Address - Country:US
Mailing Address - Phone:787-833-2234
Mailing Address - Fax:
Practice Address - Street 1:12 CALLE VALLADOLID
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-5164
Practice Address - Country:US
Practice Address - Phone:787-833-2234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist