Provider Demographics
NPI:1548988801
Name:VEGA RAMIREZ, GISELLY MARIE
Entity type:Individual
Prefix:
First Name:GISELLY
Middle Name:MARIE
Last Name:VEGA RAMIREZ
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:PANORAMA PLAZA 1 CALLE 11
Mailing Address - Street 2:APT 1205
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:939-244-9373
Mailing Address - Fax:
Practice Address - Street 1:PANORAMA PLAZA 1 CALLE 11
Practice Address - Street 2:APT 1205
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:939-244-9373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR2423183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program