Provider Demographics
NPI:1154792943
Name:TRINIDAD, PAOLA NOELIA (TECNICO DE FARMACIA)
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:NOELIA
Last Name:TRINIDAD
Suffix:
Gender:F
Credentials:TECNICO DE FARMACIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 931 KM 2.0
Mailing Address - Street 2:BO. NAVARRO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-0000
Mailing Address - Country:US
Mailing Address - Phone:787-687-2584
Mailing Address - Fax:787-743-2537
Practice Address - Street 1:CARR 931 KM 2.0
Practice Address - Street 2:BO. NAVARRO
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-0000
Practice Address - Country:US
Practice Address - Phone:787-387-2584
Practice Address - Fax:787-743-2537
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR37762183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR37762OtherTECNICO DE FARMACIA