Provider Demographics
NPI:1780268565
Name:VIRELLA CARTAGENA, JONATHAN (CPTH)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:VIRELLA CARTAGENA
Suffix:
Gender:M
Credentials:CPTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:HACIENDA EL PILAR
Mailing Address - Street 2:4005 CALLE REYNA MORA
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-9512
Mailing Address - Country:US
Mailing Address - Phone:787-718-8979
Mailing Address - Fax:
Practice Address - Street 1:CALLE 4 #48 JARDINES
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-0095
Practice Address - Country:US
Practice Address - Phone:787-870-5599
Practice Address - Fax:787-273-4433
Is Sole Proprietor?:No
Enumeration Date:2021-05-08
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR13344183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician