Healthcare Provider Details

I. General information

NPI: 1659573533
Provider Name (Legal Business Name): LYMARI DE JESUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

POBLADO SAN ANTONIO CARR 110 KM 6.2
AGUADILLA PR
00690
US

IV. Provider business mailing address

PO BOX 1811
AGUADILLA PR
00605-1811
US

V. Phone/Fax

Practice location:
  • Phone: 787-890-3535
  • Fax: 787-890-3535
Mailing address:
  • Phone: 939-640-4190
  • Fax: 877-204-3025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: