Provider Demographics
NPI:1558575886
Name:LEBRON, MARIA (RPH)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LEBRON
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 2500
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-2500
Mailing Address - Country:US
Mailing Address - Phone:787-283-6525
Mailing Address - Fax:
Practice Address - Street 1:715 AVE PONCE DE LEON
Practice Address - Street 2:
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00917-5032
Practice Address - Country:US
Practice Address - Phone:787-758-2000
Practice Address - Fax:787-771-7884
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist