Provider Demographics
NPI:1992942312
Name:CAPELLA, LYNNETTE (PH TECH)
Entity type:Individual
Prefix:MRS
First Name:LYNNETTE
Middle Name:
Last Name:CAPELLA
Suffix:
Gender:F
Credentials:PH TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVE SAN CARLOS
Mailing Address - Street 2:ESQUINA COMERCIO 1
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:787-890-1034
Mailing Address - Fax:
Practice Address - Street 1:AVE SAN CARLOS
Practice Address - Street 2:ESQ COMERCIO 1
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00605
Practice Address - Country:US
Practice Address - Phone:787-890-1034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003709183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician