Provider Demographics
NPI:1588701502
Name:SIERRA, IRMA
Entity type:Individual
Prefix:
First Name:IRMA
Middle Name:
Last Name:SIERRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 AVE SANTIAGO IGLESIAS
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-4700
Mailing Address - Country:US
Mailing Address - Phone:787-878-2450
Mailing Address - Fax:787-878-2450
Practice Address - Street 1:158 AVE SANTIAGO IGLESIAS
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4700
Practice Address - Country:US
Practice Address - Phone:787-878-2450
Practice Address - Fax:787-878-2450
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2813183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist