Provider Demographics
NPI:1992418255
Name:CHARNECO GONZALEZ, JUANETZIEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JUANETZIEL
Middle Name:
Last Name:CHARNECO GONZALEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 5 BOX 107927
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-9774
Mailing Address - Country:US
Mailing Address - Phone:787-215-8551
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA ESTATAL PR 2 KM 101.0
Practice Address - Street 2:
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678
Practice Address - Country:US
Practice Address - Phone:787-895-0808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8043183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist