Provider Demographics
NPI:1427788355
Name:BELTRAN ROSARIO, STEPHANIE ROSALY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ROSALY
Last Name:BELTRAN ROSARIO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 CALLE GERARDO MEJIAS
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923-3206
Mailing Address - Country:US
Mailing Address - Phone:787-639-6750
Mailing Address - Fax:
Practice Address - Street 1:AVE. TENIENTE GONZALEZ ESQ. CALLE NOGAL LOMAS VERDES
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-620-9618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6946183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6946OtherSTATE LICENSE