Provider Demographics
NPI:1376526038
Name:ROLDAN, LUZ HARIA (LPN)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:HARIA
Last Name:ROLDAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND GOLDEN VIEW PLAZA
Mailing Address - Street 2:APARTAMETO 1906
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:787-764-9904
Practice Address - Street 1:AVEUDA 65 INFANTERIA KI B4
Practice Address - Street 2:BARRIO SABANA LLANA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00954
Practice Address - Country:US
Practice Address - Phone:787-767-7676
Practice Address - Fax:787-764-9904
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR012264164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse