Provider Demographics
NPI:1649820713
Name:GOMEZ MARTINEZ, MONICA (PHARMD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:GOMEZ MARTINEZ
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:PO BOX 71500
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8600
Mailing Address - Country:US
Mailing Address - Phone:787-622-3000
Mailing Address - Fax:
Practice Address - Street 1:BECHARA INDUSTRIAL PARK
Practice Address - Street 2:CALLE SEGARRA EDIF. #411, AVE. MARGINAL KENNEDY
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920
Practice Address - Country:US
Practice Address - Phone:787-622-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6555183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist