Provider Demographics
NPI:1912293473
Name:NAVEDO, NEIDA
Entity Type:Individual
Prefix:MRS
First Name:NEIDA
Middle Name:
Last Name:NAVEDO
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 1:100 BOULEVARD DR
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-6624
Mailing Address - Country:US
Mailing Address - Phone:787-397-2353
Mailing Address - Fax:
Practice Address - Street 1:100 BOULEVARD DR
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-6624
Practice Address - Country:US
Practice Address - Phone:787-394-2353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3032183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist