Provider Demographics
NPI:1154780070
Name:SALGADO, MARIELA (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARIELA
Middle Name:
Last Name:SALGADO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CARRETERA PR KM 84.7
Mailing Address - Street 2:PLAZA DEL MAR SHOPPING MALL
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-0000
Mailing Address - Country:US
Mailing Address - Phone:787-544-4855
Mailing Address - Fax:787-544-3122
Practice Address - Street 1:2 CARRETERA PR KM 84.7
Practice Address - Street 2:PLAZA DEL MAR SHOPPING MALL
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-0000
Practice Address - Country:US
Practice Address - Phone:787-544-4855
Practice Address - Fax:787-544-3122
Is Sole Proprietor?:No
Enumeration Date:2016-02-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist