Basic Information
| Provider Information | |||||||||
| NPI: | 1417154873 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ORLANDO | ||||||||
| FirstName: | BRENDA | ||||||||
| MiddleName: | ENID | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMACY TECHNICIAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | URBANIZACION SAN PEDRO, A-2 | ||||||||
| Address2: | |||||||||
| City: | FAJARDO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878601603 | ||||||||
| FaxNumber: | 7878601614 | ||||||||
| Practice Location | |||||||||
| Address1: | PLAZA BONZAI | ||||||||
| Address2: | NO. 251 | ||||||||
| City: | FAJARDO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878601603 | ||||||||
| FaxNumber: | 7878601614 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183700000X | 1996 | PR | Y | Pharmacy Service Providers | Pharmacy Technician |
No ID Information.