Provider Demographics
NPI:1053796037
Name:BONET, DAMARIS JOHANNA
Entity type:Individual
Prefix:
First Name:DAMARIS
Middle Name:JOHANNA
Last Name:BONET
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:PO BOX 1182
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-1182
Mailing Address - Country:US
Mailing Address - Phone:787-231-5685
Mailing Address - Fax:
Practice Address - Street 1:140 BO LLANADAS
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-2927
Practice Address - Country:US
Practice Address - Phone:787-970-3542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6809183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4574580OtherDRIVER LICENSE