Provider Demographics
NPI:1215090477
Name:CORREA, HILDA M (PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:HILDA
Middle Name:M
Last Name:CORREA
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:CALLE 1 F-7
Mailing Address - Street 2:PARQUE MONTEBELLO
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-0000
Mailing Address - Country:US
Mailing Address - Phone:787-761-5658
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 199
Practice Address - Street 2:SAN JUAN WELLNESS CENTER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-0000
Practice Address - Country:US
Practice Address - Phone:787-761-8132
Practice Address - Fax:787-761-8102
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1743183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist