Provider Demographics
NPI:1982820007
Name:OQUENDO, BRENDA ROSA (RPH)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:ROSA
Last Name:OQUENDO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#52 CALLE PRINCESA
Mailing Address - Street 2:ESTANCIA DE LA FUENTE
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-3608
Mailing Address - Country:US
Mailing Address - Phone:787-251-5761
Mailing Address - Fax:787-796-8747
Practice Address - Street 1:CALLE MENDEZ VIGO 269
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-796-1155
Practice Address - Fax:787-796-8747
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4063183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist