Provider Demographics
NPI:1033345087
Name:ARMENTEROS, JOSE CALAZAN DIAZ (PHARM TECH)
Entity type:Individual
Prefix:
First Name:JOSE CALAZAN
Middle Name:DIAZ
Last Name:ARMENTEROS
Suffix:
Gender:M
Credentials:PHARM TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CALLE VIDAL FELIX
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-1817
Mailing Address - Country:US
Mailing Address - Phone:787-898-2525
Mailing Address - Fax:
Practice Address - Street 1:135 CALLE VIDAL FELIX
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-1817
Practice Address - Country:US
Practice Address - Phone:787-898-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7053183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician