Basic Information
| Provider Information | |||||||||
| NPI: | 1790316842 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FIGUEROA-MORALES | ||||||||
| FirstName: | MARIELI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 540 CARR. 169 BALCONES DE GUAYNABO | ||||||||
| Address2: | APARTMENT 702 | ||||||||
| City: | GUAYNABO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00969 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873765458 | ||||||||
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| Practice Location | |||||||||
| Address1: | AVE PONCE DE LEON 715 PDA 37 1/2 | ||||||||
| Address2: | |||||||||
| City: | HATO REY | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877582000 | ||||||||
| FaxNumber: | 7877717884 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/28/2020 | ||||||||
| LastUpdateDate: | 01/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 5076 | PR | Y | 193400000X SINGLE SPECIALTY GROUP | Pharmacy Service Providers | Pharmacist |
No ID Information.