Provider Demographics
NPI:1912108036
Name:PABON, LYMARI (CPHT)
Entity Type:Individual
Prefix:
First Name:LYMARI
Middle Name:
Last Name:PABON
Suffix:
Gender:F
Credentials:CPHT
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 1905
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-1905
Mailing Address - Country:US
Mailing Address - Phone:787-414-9720
Mailing Address - Fax:787-856-1922
Practice Address - Street 1:CENTRO COMERCIAL LA QUINTA
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-1905
Practice Address - Country:US
Practice Address - Phone:787-414-9720
Practice Address - Fax:787-856-1922
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4740183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4740OtherPHARMACY TECHNICIAN