Provider Demographics
NPI:1134375231
Name:PASTOR, CARMEN J (PHT)
Entity type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:J
Last Name:PASTOR
Suffix:
Gender:F
Credentials:PHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND PARQUE DE SAN JUAN # 2404
Mailing Address - Street 2:AVE. BLVD 851
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909-3339
Mailing Address - Country:US
Mailing Address - Phone:787-996-7679
Mailing Address - Fax:
Practice Address - Street 1:851 BLVD SAGRADO CORAZON APT 2404
Practice Address - Street 2:AVE. BLVD 851
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-3344
Practice Address - Country:US
Practice Address - Phone:787-996-7679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14415183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician