Provider Demographics
NPI:1801056957
Name:CORIANO, VIRGEN M
Entity type:Individual
Prefix:
First Name:VIRGEN
Middle Name:M
Last Name:CORIANO
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:E STREET NUM E 2
Mailing Address - Street 2:JARDINES DE BUENA VISTA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-769-8423
Mailing Address - Fax:
Practice Address - Street 1:E STREET NUM E 2
Practice Address - Street 2:JARDINES DE BUENA VISTA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-769-8423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR005813183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR005813OtherPHARMACY BOARD