Provider Demographics
NPI:1104958958
Name:MAESTRE, AILEEN JANETTE (PHARMACIST)
Entity type:Individual
Prefix:
First Name:AILEEN
Middle Name:JANETTE
Last Name:MAESTRE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. DIAMOND VILLAGE CALLE #1
Mailing Address - Street 2:B-9
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-258-8278
Mailing Address - Fax:787-282-6845
Practice Address - Street 1:URB. DIAMOND VILLAGE CALLE #1
Practice Address - Street 2:B-9
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-258-8278
Practice Address - Fax:787-282-6845
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist