Basic Information
| Provider Information | |||||||||
| NPI: | 1013075274 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIGUEROA | ||||||||
| FirstName: | JORGE | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 113 CALLE POMAROSA | ||||||||
| Address2: | CIUDAD JARDIN III | ||||||||
| City: | TOA ALTA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009534804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877303803 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10 CALLE CASIA | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009213200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876417582 | ||||||||
| FaxNumber: | 7876418011 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2006 | ||||||||
| LastUpdateDate: | 07/20/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 3648 | PR | N | Pharmacy Service Providers | Pharmacist | 1835P0018X | 3648 | PR | Y | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
No ID Information.