Provider Demographics
NPI:1831586569
Name:DIAZ-SIERRA, EDNA CRISTINA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:EDNA
Middle Name:CRISTINA
Last Name:DIAZ-SIERRA
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 1:668 CALLE BERNADETTE ALTOS
Mailing Address - Street 2:URB. LOURDES
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-3807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:580 MARGINAL BUCHANAN
Practice Address - Street 2:EXT. VILLA CAPARRA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-1706
Practice Address - Country:US
Practice Address - Phone:787-776-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist