Provider Demographics
NPI:1447394317
Name:CUBILLAN, YAHAIRA
Entity type:Individual
Prefix:
First Name:YAHAIRA
Middle Name:
Last Name:CUBILLAN
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:HC 1 BOX 6063
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971-9535
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:586 CALLE NAPOLES
Practice Address - Street 2:VILLA CAPRI
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-4604
Practice Address - Country:US
Practice Address - Phone:787-755-2240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5871183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician