Provider Demographics
NPI:1962121459
Name:FLORES MARTINEZ, NILSA PAOLA (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:MRS
First Name:NILSA
Middle Name:PAOLA
Last Name:FLORES MARTINEZ
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1346
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-1346
Mailing Address - Country:US
Mailing Address - Phone:787-736-0069
Mailing Address - Fax:
Practice Address - Street 1:CARR 181 KM 0.3 R 745 BO ESPINO
Practice Address - Street 2:
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754
Practice Address - Country:US
Practice Address - Phone:787-736-0069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR013840183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician