Provider Demographics
NPI:1255489951
Name:LEBRON, OLGA E (RPH)
Entity Type:Individual
Prefix:MS
First Name:OLGA
Middle Name:E
Last Name:LEBRON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 953
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-0953
Mailing Address - Country:US
Mailing Address - Phone:787-292-1265
Mailing Address - Fax:787-293-0872
Practice Address - Street 1:LC49 VIA ATENAS
Practice Address - Street 2:ENCANTADA
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-6103
Practice Address - Country:US
Practice Address - Phone:787-292-1265
Practice Address - Fax:787-293-0872
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003227183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist