Provider Demographics
NPI:1417081605
Name:NAZARIO, JAVIER E (RPH)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:E
Last Name:NAZARIO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 CALLE LA PAZ
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-3208
Mailing Address - Country:US
Mailing Address - Phone:787-252-9023
Mailing Address - Fax:
Practice Address - Street 1:201 AVE ALGARROBO
Practice Address - Street 2:CENTRO COMERCIAL, SUITE 1
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-6333
Practice Address - Country:US
Practice Address - Phone:787-254-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4968183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist