Healthcare Provider Details

I. General information

NPI: 1639626583
Provider Name (Legal Business Name): MIGDALIA M LOUBRIEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2016
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AQ 62 RIO PORTUGUEZ VALLE VERDE
BAYAMON PR
00961
US

IV. Provider business mailing address

AQ62 CALLE RIO PORTUGUES BAYAMON
BAYAMON PR
00961-3205
US

V. Phone/Fax

Practice location:
  • Phone: 787-615-1210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3635
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: