Provider Demographics
NPI:1922212398
Name:CORTES, LOURDES (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:
Last Name:CORTES
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CIUDAD JARDIN DE BAIROA
Mailing Address - Street 2:GRANADA 46
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00737
Mailing Address - Country:US
Mailing Address - Phone:787-760-1280
Mailing Address - Fax:787-283-3673
Practice Address - Street 1:FARMACIA SARIMAR
Practice Address - Street 2:SAN CLAUDIO MAIL STATION
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-760-1280
Practice Address - Fax:787-283-3673
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
PR4667183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist