Healthcare Provider Details

I. General information

NPI: 1528922317
Provider Name (Legal Business Name): MRS. LOURDES DAPENA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 NW 41ST ST
DORAL FL
33166-6202
US

IV. Provider business mailing address

8678 SW 121ST ST
MIAMI FL
33156-5118
US

V. Phone/Fax

Practice location:
  • Phone: 305-586-5069
  • Fax:
Mailing address:
  • Phone: 305-586-5069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPS29602
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: