Provider Demographics
NPI:1962771352
Name:JUAN, HILDA M
Entity type:Individual
Prefix:
First Name:HILDA
Middle Name:M
Last Name:JUAN
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 1:580 MARGINAL BUCHANAN
Mailing Address - Street 2:C/O WALGREENS NARANJITO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-1706
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:580 MARGINAL BUCHANAN
Practice Address - Street 2:C/O WALGREENS NARANJITO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-1706
Practice Address - Country:US
Practice Address - Phone:787-869-0240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist