Provider Demographics
NPI:1366760753
Name:GARCIA, BRENDA (PHARMACY TEC)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PHARMACY TEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC05 BOX 55237 BO SAN ANTONIO
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-316-8737
Mailing Address - Fax:787-657-3550
Practice Address - Street 1:HC 05 BOX55237 SAN ANTONIO
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-316-8737
Practice Address - Fax:787-657-3550
Is Sole Proprietor?:No
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5243183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician