Provider Demographics
NPI:1053417790
Name:CRESPO RODRIGUEZ, CYNDIA (TECHNICIAN)
Entity type:Individual
Prefix:MRS
First Name:CYNDIA
Middle Name:
Last Name:CRESPO RODRIGUEZ
Suffix:
Gender:F
Credentials:TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1496
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767-1496
Mailing Address - Country:US
Mailing Address - Phone:787-893-7175
Mailing Address - Fax:
Practice Address - Street 1:5 CALLE CRISTOBAL COLON
Practice Address - Street 2:
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767-3328
Practice Address - Country:US
Practice Address - Phone:787-893-2280
Practice Address - Fax:787-893-6738
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5073183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5073OtherTECHNICIAN LICENSE