Provider Demographics
NPI:1437290509
Name:LOPEZ, LEYDA (RPH)
Entity Type:Individual
Prefix:
First Name:LEYDA
Middle Name:
Last Name:LOPEZ
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 1620
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-1620
Mailing Address - Country:US
Mailing Address - Phone:787-762-5805
Mailing Address - Fax:787-752-0140
Practice Address - Street 1:SUPERFRAMACIA METROPOLIS
Practice Address - Street 2:CENTRO COMERCIAL METROPOLIS
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-400-0090
Practice Address - Fax:787-762-5049
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1848183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist