Provider Demographics
NPI:1487783783
Name:SORRENTINI, MAGALY (RPH)
Entity type:Individual
Prefix:
First Name:MAGALY
Middle Name:
Last Name:SORRENTINI
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 1:33 CALLE JIMENEZ
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-4010
Mailing Address - Country:US
Mailing Address - Phone:787-255-0166
Mailing Address - Fax:
Practice Address - Street 1:33 CALLE JIMENEZ
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-4010
Practice Address - Country:US
Practice Address - Phone:787-255-0166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4281183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist