Provider Demographics
NPI:1518008507
Name:SANABRIA, LYDIA M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:M
Last Name:SANABRIA
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 1:1839 CALLE SAN BERNARDINO
Mailing Address - Street 2:ROMANY
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5427
Mailing Address - Country:US
Mailing Address - Phone:787-767-3623
Mailing Address - Fax:787-767-3623
Practice Address - Street 1:ROAD 866 KM 3.4
Practice Address - Street 2:SABANA SECA
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00952
Practice Address - Country:US
Practice Address - Phone:787-784-1357
Practice Address - Fax:787-784-1357
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1980183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist