Provider Demographics
NPI:1851849939
Name:LOPERENA BADILLO, DEBORAH MARIE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:MARIE
Last Name:LOPERENA BADILLO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 CALLE LOS CIPRESES
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-5062
Mailing Address - Country:US
Mailing Address - Phone:787-433-9907
Mailing Address - Fax:
Practice Address - Street 1:CARR ESTATAL 2 KM 802
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-879-3566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist