Provider Demographics
NPI:1720134117
Name:MORET, GLORIMAR
Entity Type:Individual
Prefix:MISS
First Name:GLORIMAR
Middle Name:
Last Name:MORET
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 1:46 CALLE ARIZONA 8
Mailing Address - Street 2:
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714-2809
Mailing Address - Country:US
Mailing Address - Phone:787-839-1491
Mailing Address - Fax:787-271-3691
Practice Address - Street 1:75 CALLE MORSE
Practice Address - Street 2:
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714-2618
Practice Address - Country:US
Practice Address - Phone:787-839-1769
Practice Address - Fax:787-271-3691
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4711183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician