Provider Demographics
NPI:1053782714
Name:VILLAR, YAMILEX
Entity type:Individual
Prefix:
First Name:YAMILEX
Middle Name:
Last Name:VILLAR
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 1:165 CAMINO LOS COROZOS URB. SABANERA DEL RIO
Mailing Address - Street 2:NAVARRO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-635-5573
Mailing Address - Fax:787-737-0973
Practice Address - Street 1:165 CAMINO LOS COROZOS URB. SABANERA DEL RIO
Practice Address - Street 2:NAVARRO
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778
Practice Address - Country:US
Practice Address - Phone:787-635-5573
Practice Address - Fax:787-737-0973
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2611183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician