Provider Demographics
NPI:1992098578
Name:CAMACHO-JUSINO, YARLYN LUISETTE (PHAMD)
Entity type:Individual
Prefix:DR
First Name:YARLYN
Middle Name:LUISETTE
Last Name:CAMACHO-JUSINO
Suffix:
Gender:F
Credentials:PHAMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 CALLE ESTRELLA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-3829
Mailing Address - Country:US
Mailing Address - Phone:787-848-3137
Mailing Address - Fax:
Practice Address - Street 1:CARR 121 KM 13.3 SECTOR CUATRO CALLES
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-987-8236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5288183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist