Provider Demographics
NPI:1154831469
Name:FAMILIA CORTES-LEBRON, LLC
Entity Type:Organization
Organization Name:FAMILIA CORTES-LEBRON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBRON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:787-923-7178
Mailing Address - Street 1:1100 CARR 116 STE 1
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-4693
Mailing Address - Country:US
Mailing Address - Phone:787-987-8036
Mailing Address - Fax:787-987-8234
Practice Address - Street 1:CARR 121 KM 13.3
Practice Address - Street 2:SECTOR CUATRO CALLES, BO. SUSUA BAJA
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-987-8036
Practice Address - Fax:787-987-8234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-02
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19F35123336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy