Provider Demographics
NPI:1215472782
Name:CRUET TORRES, JOANEL (PHARMD)
Entity type:Individual
Prefix:
First Name:JOANEL
Middle Name:
Last Name:CRUET TORRES
Suffix:
Gender:F
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:PO BOX 560722
Mailing Address - Street 2:
Mailing Address - City:GUAYANILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00656-3722
Mailing Address - Country:US
Mailing Address - Phone:787-925-4210
Mailing Address - Fax:
Practice Address - Street 1:73 CALLE SANTA CRUZ
Practice Address - Street 2:SUITE # 101
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6910
Practice Address - Country:US
Practice Address - Phone:787-798-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2016-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6449183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist