Provider Demographics
NPI:1972630390
Name:NOVALES, MICHELLE D. TORRES
Entity type:Individual
Prefix:
First Name:MICHELLE D.
Middle Name:TORRES
Last Name:NOVALES
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 1:42 URB LIRIOS DEL VALLE
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-9890
Mailing Address - Country:US
Mailing Address - Phone:787-486-6164
Mailing Address - Fax:
Practice Address - Street 1:44 URB LIRIOS DEL VALLE
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-9891
Practice Address - Country:US
Practice Address - Phone:787-486-6164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4854183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician