Provider Demographics
NPI:1487865416
Name:SUAREZ, WILNELIA
Entity type:Individual
Prefix:
First Name:WILNELIA
Middle Name:
Last Name:SUAREZ
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:PMB 182
Mailing Address - Street 2:CAMPO RICO AVE. 779
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-0000
Mailing Address - Country:US
Mailing Address - Phone:787-562-8296
Mailing Address - Fax:787-757-5731
Practice Address - Street 1:255 CALLE SAN FRANCISCO
Practice Address - Street 2:OLD SAN JUAN
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-1724
Practice Address - Country:US
Practice Address - Phone:787-722-0335
Practice Address - Fax:787-725-8292
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4398183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician