Provider Demographics
NPI:1912167206
Name:CORDERO, LOURDES DEL PILAR (OPTOMETRIST OD)
Entity Type:Individual
Prefix:DR
First Name:LOURDES
Middle Name:DEL PILAR
Last Name:CORDERO
Suffix:
Gender:F
Credentials:OPTOMETRIST OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TIERRALTA II - 0-5 LAS AGUILAS ST
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-403-7408
Mailing Address - Fax:787-720-0321
Practice Address - Street 1:WALMART VISION CENTER
Practice Address - Street 2:PARQUE ESCORIAL
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-257-0500
Practice Address - Fax:787-257-0670
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR541152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist