Healthcare Provider Details

I. General information

NPI: 1184529240
Provider Name (Legal Business Name): LIRIO ENID ROBLES CORDERO MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 AVE 65 INFANTERIA STE 205
CAROLINA PR
00985-5615
US

IV. Provider business mailing address

1886 CALLE FRANCISCO QUINDOS
SAN JUAN PR
00926-7734
US

V. Phone/Fax

Practice location:
  • Phone: 787-701-4141
  • Fax:
Mailing address:
  • Phone: 787-934-5275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number16499
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: