Provider Demographics
NPI:1144021601
Name:AVILES RUIZ, DANIA MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIA
Middle Name:MARIE
Last Name:AVILES RUIZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 5 BOX 25866
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-9477
Mailing Address - Country:US
Mailing Address - Phone:813-503-5510
Mailing Address - Fax:
Practice Address - Street 1:SUPER FARMACIA CORCOVADA
Practice Address - Street 2:CARR 492 KM 2.3 BARRIO CORCOVADA
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-820-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8379183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty