Provider Demographics
NPI:1962266940
Name:REYES SANCHEZ, KRISTAL ROSUAN
Entity type:Individual
Prefix:DR
First Name:KRISTAL
Middle Name:ROSUAN
Last Name:REYES SANCHEZ
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 1:500 CALLE ANDALUCIA APT 42
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-5865
Mailing Address - Country:US
Mailing Address - Phone:787-314-3381
Mailing Address - Fax:
Practice Address - Street 1:CARR #2 KM 173.4
Practice Address - Street 2:BO CAIN ALTO
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-892-1860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist