Provider Demographics
NPI:1205055456
Name:WALKER, NEREIDA
Entity type:Individual
Prefix:
First Name:NEREIDA
Middle Name:
Last Name:WALKER
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:CALLE GRANADA NO 95
Mailing Address - Street 2:BUENA VISTA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-404-7885
Mailing Address - Fax:787-769-5353
Practice Address - Street 1:STATION 5 800 AVE RAFAEL HDZ MARIN
Practice Address - Street 2:FARMACIA AMIGA DE MONTECARLO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-5288
Practice Address - Country:US
Practice Address - Phone:787-762-1616
Practice Address - Fax:787-769-5353
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1856183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician