Provider Demographics
NPI:1407902117
Name:LIZZETTE ECHEVERRIA QUINONES
Entity Type:Organization
Organization Name:LIZZETTE ECHEVERRIA QUINONES
Other - Org Name:FARMACIA COTO LAUREL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACISTOWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIZZETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ECHEVERRIA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-984-1008
Mailing Address - Street 1:4 CALLE CENTRAL
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2110
Mailing Address - Country:US
Mailing Address - Phone:787-984-1008
Mailing Address - Fax:787-848-7117
Practice Address - Street 1:4 CALLE CENTRAL
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2110
Practice Address - Country:US
Practice Address - Phone:787-984-1008
Practice Address - Fax:787-848-7117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09F13543336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR634249OtherSARAFS
PR4019356OtherNABP
PRDF020248OtherPR CONTROLLED SUBSTANCE R
PRDF020248OtherPR CONTROLLED SUBSTANCE R