Provider Demographics
NPI:1194603217
Name:BOU, CLARA I (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:CLARA
Middle Name:I
Last Name:BOU
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 AVE LOPATEGUI APT 241
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4569
Mailing Address - Country:US
Mailing Address - Phone:939-645-0358
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 520
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00970-0520
Practice Address - Country:US
Practice Address - Phone:939-645-0358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3862183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist