Provider Demographics
NPI:1679396956
Name:DONATIU GOMEZ, TAMARIX (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TAMARIX
Middle Name:
Last Name:DONATIU GOMEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 CALLE DIAMANTE
Mailing Address - Street 2:URB. TERRAZAS DEMAJAGUA 2
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738
Mailing Address - Country:US
Mailing Address - Phone:787-354-8786
Mailing Address - Fax:
Practice Address - Street 1:URB. TERRAZAS DEMAJAGUA 2
Practice Address - Street 2:204 CALLE DIAMANTE
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-0073
Practice Address - Country:US
Practice Address - Phone:787-354-8786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist