Provider Demographics
NPI:1730725979
Name:REYES, ROCHELLY
Entity type:Individual
Prefix:
First Name:ROCHELLY
Middle Name:
Last Name:REYES
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:VIA MORENILLA SJ 96
Mailing Address - Street 2:HACIENDA SAN JOSE
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-3302
Mailing Address - Country:US
Mailing Address - Phone:787-319-1146
Mailing Address - Fax:
Practice Address - Street 1:83 CALLE BETANCES
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3514
Practice Address - Country:US
Practice Address - Phone:787-743-2000
Practice Address - Fax:787-746-2001
Is Sole Proprietor?:No
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4303183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist