Provider Demographics
NPI:1295923589
Name:CASANOVA, NOEMI (RPH)
Entity type:Individual
Prefix:MRS
First Name:NOEMI
Middle Name:
Last Name:CASANOVA
Suffix:
Gender:F
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:URB. SAN AGUSTIN
Mailing Address - Street 2:118 CALLE SAN BRUNO
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-5684
Mailing Address - Country:US
Mailing Address - Phone:787-380-2060
Mailing Address - Fax:
Practice Address - Street 1:URB. SAN AGUSTIN
Practice Address - Street 2:118 CALLE SAN BRUNO
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-5684
Practice Address - Country:US
Practice Address - Phone:787-380-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3664183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist