Provider Demographics
NPI:1174992200
Name:MARTIN RESTO, MEY LING
Entity type:Individual
Prefix:
First Name:MEY LING
Middle Name:
Last Name:MARTIN RESTO
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:HC 75 BOX 1873
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00719
Mailing Address - Country:UM
Mailing Address - Phone:787-516-8930
Mailing Address - Fax:787-875-3550
Practice Address - Street 1:HC 75 BOX 1873
Practice Address - Street 2:
Practice Address - City:NARANJITO
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00719
Practice Address - Country:UM
Practice Address - Phone:787-516-8930
Practice Address - Fax:787-875-3550
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10694183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician