Provider Demographics
NPI:1255591756
Name:FELICIER, CARMEN J
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:J
Last Name:FELICIER
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:PO BOX 2413
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-2413
Mailing Address - Country:US
Mailing Address - Phone:787-463-8682
Mailing Address - Fax:
Practice Address - Street 1:CALLE J A 21 URB MONTE BRISAS
Practice Address - Street 2:FARMACIA MONTE BRISAS
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-0000
Practice Address - Country:US
Practice Address - Phone:787-463-8682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002165183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist