Provider Demographics
NPI:1548478159
Name:FEBLES, CARMEN HAYDEE
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:HAYDEE
Last Name:FEBLES
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 1:267 CALLE PABONA
Mailing Address - Street 2:LLANOS DEL SUR
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2818
Mailing Address - Country:US
Mailing Address - Phone:787-844-1084
Mailing Address - Fax:787-844-0180
Practice Address - Street 1:2188 AVE EDUARDO RUBERTE STE 105
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-0601
Practice Address - Country:US
Practice Address - Phone:787-844-1084
Practice Address - Fax:787-844-0180
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2636183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician