Provider Demographics
NPI:1215458989
Name:CARLES JULIA, EDWIN
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:
Last Name:CARLES JULIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:EDWIN
Other - Middle Name:
Other - Last Name:CARLES JULIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:PO BOX 1014
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-1014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:COND DANZA DEL SOL APT 408
Practice Address - Street 2:BO JOYUDA
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:787-637-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-03
Last Update Date:2017-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist