Provider Demographics
NPI:1568496214
Name:LESPIER-DEXTER, LAURA ELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELENA
Last Name:LESPIER-DEXTER
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:B STREET #C LA COLINA
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-798-4527
Mailing Address - Fax:787-798-5540
Practice Address - Street 1:B STREET #C LA COLINA
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-798-4527
Practice Address - Fax:787-798-5540
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3979174400000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE08217Medicare UPIN
PRE08217Medicare UPIN