Provider Demographics
NPI:1669407367
Name:CONDE, SORAYA (RPH)
Entity type:Individual
Prefix:MRS
First Name:SORAYA
Middle Name:
Last Name:CONDE
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:AL5 VIA ELENA
Mailing Address - Street 2:VILLA FONTANA,
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-3901
Mailing Address - Country:US
Mailing Address - Phone:787-701-2440
Mailing Address - Fax:
Practice Address - Street 1:KM 12.6 65 TH INFANTRY AVE.
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-257-5949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4630183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist