Provider Demographics
NPI:1669537288
Name:GARCIA, AMARILIS
Entity type:Individual
Prefix:
First Name:AMARILIS
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE VILLA ICACO A-180
Mailing Address - Street 2:URB. EL PLANTIO
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-955-5281
Mailing Address - Fax:
Practice Address - Street 1:A180 CALLE VILLA ICACO
Practice Address - Street 2:URB. EL PLANTIO
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-4475
Practice Address - Country:US
Practice Address - Phone:787-955-5281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4146183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician