Provider Demographics
NPI:1750481339
Name:BADO, LIZETTE V (RPH)
Entity Type:Individual
Prefix:MR
First Name:LIZETTE
Middle Name:V
Last Name:BADO
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 947
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-0947
Mailing Address - Country:US
Mailing Address - Phone:787-733-6981
Mailing Address - Fax:
Practice Address - Street 1:5 CALLE CRISTOBAL COLON
Practice Address - Street 2:
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767-3328
Practice Address - Country:US
Practice Address - Phone:787-893-2280
Practice Address - Fax:787-893-5819
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4211183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4211OtherRPH LINCENSE