Provider Demographics
NPI:1255624979
Name:LEGARRETA, JUAN F (RPH)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:F
Last Name:LEGARRETA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CALLE SOL
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-3950
Mailing Address - Country:US
Mailing Address - Phone:787-204-8309
Mailing Address - Fax:
Practice Address - Street 1:643 YAUCO PLAZA II
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-4448
Practice Address - Country:US
Practice Address - Phone:787-267-5727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4334183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist