Basic Information
| Provider Information | |||||||||
| NPI: | 1497181135 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ESTEVA | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.PH. | ||||||||
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| Mailing Information | |||||||||
| Address1: | MIRAMELINDA 792 | ||||||||
| Address2: | HACIENDA FLORIDA | ||||||||
| City: | YAUCO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00698 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872677577 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | MIRAMELINDA 792 | ||||||||
| Address2: | HACIENDA FLORIDA | ||||||||
| City: | YAUCO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00698 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872677577 | ||||||||
| FaxNumber: | 7872676630 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2013 | ||||||||
| LastUpdateDate: | 09/25/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 4752 | PR | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.