Provider Demographics
NPI:1912158007
Name:PINEIRO, CARMEN IRIS
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:IRIS
Last Name:PINEIRO
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 1:1 CALLE JUAN T PUIG
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-2700
Mailing Address - Country:US
Mailing Address - Phone:787-846-0125
Mailing Address - Fax:121-846-0125
Practice Address - Street 1:CALLE JUAN T. PUIG#1
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-846-0125
Practice Address - Fax:787-846-0125
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002718183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician