Provider Demographics
NPI:1194883033
Name:CRESPO, YARELLYS ENID
Entity type:Individual
Prefix:MRS
First Name:YARELLYS
Middle Name:ENID
Last Name:CRESPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 8239
Mailing Address - Street 2:
Mailing Address - City:LAS MARIAS
Mailing Address - State:PR
Mailing Address - Zip Code:00670-9007
Mailing Address - Country:US
Mailing Address - Phone:787-349-3668
Mailing Address - Fax:
Practice Address - Street 1:95 AVE MATIAS BRUGMAN
Practice Address - Street 2:
Practice Address - City:LAS MARIAS
Practice Address - State:PR
Practice Address - Zip Code:00670-2009
Practice Address - Country:US
Practice Address - Phone:787-827-3165
Practice Address - Fax:787-827-3165
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4907183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician