Healthcare Provider Details

I. General information

NPI: 1902014954
Provider Name (Legal Business Name): LOURDES BERRIOS SANTOS PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE BARCELO #64
CIDRA PR
00739-3438
US

IV. Provider business mailing address

PO BOX 1257
CIDRA PR
00739-1257
US

V. Phone/Fax

Practice location:
  • Phone: 787-739-8300
  • Fax: 787-739-6300
Mailing address:
  • Phone: 787-739-8300
  • Fax: 787-739-6300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3653
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: