Provider Demographics
NPI:1538318084
Name:LANDRON, EVA
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:LANDRON
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 1:888 AVE ASHFORD
Mailing Address - Street 2:APT 10
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1007
Mailing Address - Country:US
Mailing Address - Phone:917-657-7509
Mailing Address - Fax:
Practice Address - Street 1:204 CALLE UN
Practice Address - Street 2:URBANIZACION HUYKE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2418
Practice Address - Country:US
Practice Address - Phone:787-765-6334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR206622084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry