Provider Demographics
NPI:1548223308
Name:BELTRAN, LYDIA E (MD)
Entity Type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:E
Last Name:BELTRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SAN GREGORIO ST. 1431 ALTAMESA
Mailing Address - Street 2:
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00921
Mailing Address - Country:UM
Mailing Address - Phone:787-783-5170
Mailing Address - Fax:787-272-3943
Practice Address - Street 1:SAN GREGORIO ST.1431 ALTAMESA
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00936-3628
Practice Address - Country:US
Practice Address - Phone:787-277-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR010586174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR88892BEOtherTRIPLE S MEMBER NUMBER