Provider Demographics
NPI:1023557014
Name:MENENDEZ TORRES, LISANDRA (PHARMD)
Entity Type:Individual
Prefix:
First Name:LISANDRA
Middle Name:
Last Name:MENENDEZ TORRES
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:CARR ESTATAL 153 KM 7.2
Mailing Address - Street 2:BO JAUCA 2
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757
Mailing Address - Country:US
Mailing Address - Phone:787-971-1011
Mailing Address - Fax:
Practice Address - Street 1:CARR ESTATAL 153 KM 7.2
Practice Address - Street 2:BO JAUCA 2
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757
Practice Address - Country:US
Practice Address - Phone:787-971-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6402183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6402OtherRPH LIC