Provider Demographics
NPI:1134990914
Name:NAVARRO, VILMA ROSMERY
Entity type:Individual
Prefix:
First Name:VILMA
Middle Name:ROSMERY
Last Name:NAVARRO
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 1:2 CENTENNIAL DR
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-7911
Mailing Address - Country:US
Mailing Address - Phone:781-730-8467
Mailing Address - Fax:
Practice Address - Street 1:306 PARK AVE APT 1
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-5256
Practice Address - Country:US
Practice Address - Phone:617-669-6362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPT29786183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician