Provider Demographics
NPI:1689108854
Name:NEGRON, LOURDES Y
Entity Type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:Y
Last Name:NEGRON
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 1:738 CALLE ENRIQUE LAGUERRE
Mailing Address - Street 2:ESTANCIAS DEL GOLF
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730
Mailing Address - Country:US
Mailing Address - Phone:787-432-7747
Mailing Address - Fax:787-842-8185
Practice Address - Street 1:738 CALLE ENRIQUE LAGUERRE
Practice Address - Street 2:ESTANCIAS DEL GOLF
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730
Practice Address - Country:US
Practice Address - Phone:787-432-7747
Practice Address - Fax:787-842-8185
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist