Provider Demographics
NPI:1881605376
Name:CARRASQUILLO, MARISA (RPH)
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:CARRASQUILLO
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:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:PATILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00723-0726
Mailing Address - Country:US
Mailing Address - Phone:787-839-2730
Mailing Address - Fax:787-271-0513
Practice Address - Street 1:18 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723-2607
Practice Address - Country:US
Practice Address - Phone:787-839-2730
Practice Address - Fax:787-271-0513
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist