Provider Demographics
NPI:1356721211
Name:MARCANO, ENID (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ENID
Middle Name:
Last Name:MARCANO
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 1:383 AVENIDA FD ROOSEVELT
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2131
Mailing Address - Country:US
Mailing Address - Phone:787-993-7970
Mailing Address - Fax:
Practice Address - Street 1:383 AVE FD ROOSEVELT
Practice Address - Street 2:SUITE 304
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2143
Practice Address - Country:US
Practice Address - Phone:787-993-7970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5544183500000X
FLPS42883183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist