Provider Demographics
NPI:1366735052
Name:BERRIOS-MORALES, KRYSTAL (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:KRYSTAL
Middle Name:
Last Name:BERRIOS-MORALES
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 CARR 167
Mailing Address - Street 2:PLAZA TROPICAL
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-5554
Mailing Address - Country:US
Mailing Address - Phone:787-395-7480
Mailing Address - Fax:787-395-7482
Practice Address - Street 1:550 CARR 167
Practice Address - Street 2:PLAZA TROPICAL
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5554
Practice Address - Country:US
Practice Address - Phone:787-395-7480
Practice Address - Fax:787-395-7482
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5516183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist