Healthcare Provider Details

I. General information

NPI: 1821220948
Provider Name (Legal Business Name): DRA LOURDES KUTBI PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2009
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 CALLE SANTA CRUZ STE 412 URB SANTA CRUZ
BAYAMON PR
00961-6942
US

IV. Provider business mailing address

73 CALLE SANTA CRUZ STE 412 URB SANTA CRUZ
BAYAMON PR
00961-6942
US

V. Phone/Fax

Practice location:
  • Phone: 787-778-6676
  • Fax: 787-778-6676
Mailing address:
  • Phone: 787-778-6676
  • Fax: 787-778-6676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberDPM098
License Number StatePR

VIII. Authorized Official

Name: DR. LOURDES KUTBI
Title or Position: PRESIDENT
Credential: MD
Phone: 787-778-6676