Provider Demographics
NPI:1649490798
Name:FIGUEROA FERREIRA, LACYBETH (LND)
Entity type:Individual
Prefix:
First Name:LACYBETH
Middle Name:
Last Name:FIGUEROA FERREIRA
Suffix:
Gender:F
Credentials:LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 2 D-26 VILLAS DE GURABO
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-469-0347
Mailing Address - Fax:
Practice Address - Street 1:AVE. FONT MARTELO
Practice Address - Street 2:HOSPITAL RYDER
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00792
Practice Address - Country:US
Practice Address - Phone:787-852-0768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1411133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered