Healthcare Provider Details

I. General information

NPI: 1528194891
Provider Name (Legal Business Name): LOURDES MICHELLE ESPARRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FCIA. PLAZA GARDEN HILLS PLAZA LOCAL 28
GUAYNABO PR
00966
US

IV. Provider business mailing address

194 VALLES DE TORRIMAR
GUAYNABO PR
00966
US

V. Phone/Fax

Practice location:
  • Phone: 787-781-8179
  • Fax: 787-749-9435
Mailing address:
  • Phone: 787-785-0767
  • Fax: 787-749-9435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4994
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: