Provider Demographics
NPI:1457354342
Name:DEITER, MARIA M (RPH)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:M
Last Name:DEITER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:180 PALMAS DR APT 1402
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-6354
Mailing Address - Country:US
Mailing Address - Phone:956-792-2031
Mailing Address - Fax:787-500-7377
Practice Address - Street 1:01 CARR PR-3 KM 82.5 BO. CATANO
Practice Address - Street 2:HUMACAO PLAZA
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-4667
Practice Address - Country:US
Practice Address - Phone:787-500-7377
Practice Address - Fax:787-741-6666
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX38212183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist