Provider Demographics
NPI:1366842510
Name:FIGUEROA, LILLIAM
Entity Type:Individual
Prefix:
First Name:LILLIAM
Middle Name:
Last Name:FIGUEROA
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:URB. GLENVIEW GARDENS
Mailing Address - Street 2:T19 W22B
Mailing Address - City:PONCE
Mailing Address - State:P.R
Mailing Address - Zip Code:00730
Mailing Address - Country:UM
Mailing Address - Phone:787-989-3791
Mailing Address - Fax:
Practice Address - Street 1:8169 CALLE CONCORDIA CENTRO ARARAT SUITE 412
Practice Address - Street 2:COND SAN VICENTE
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1567
Practice Address - Country:US
Practice Address - Phone:787-284-5884
Practice Address - Fax:787-284-5874
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR71194163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2646527OtherNPI
PR2646527OtherNPI