Provider Demographics
NPI:1295946226
Name:ESTREMERA, CARLOS ENRIQUE (PHARMACY)
Entity type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:ENRIQUE
Last Name:ESTREMERA
Suffix:
Gender:M
Credentials:PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 1-A-6 PARQUE SAN MIGUEL
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-251-7922
Mailing Address - Fax:
Practice Address - Street 1:CALLE SANTA CRUZ # 70
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-740-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3804183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist