Provider Demographics
NPI:1215140942
Name:VALLE-DIAZ, MARIA DEL CARMEN
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:VALLE-DIAZ
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:B8 CALLE UCAR
Mailing Address - Street 2:URB. SANTA CLARA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-6847
Mailing Address - Country:US
Mailing Address - Phone:787-782-6129
Mailing Address - Fax:787-749-9077
Practice Address - Street 1:1000 AVE JESUS T PINERO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-1819
Practice Address - Country:US
Practice Address - Phone:787-782-6129
Practice Address - Fax:787-749-9077
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician