Healthcare Provider Details

I. General information

NPI: 1558078808
Provider Name (Legal Business Name): LILLIANA RACHELLE SOTO-LOPEZ PHARMDC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2022
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ALTURAS DE HATILLO CALLE JARDIN 814
HATILLO PR
00659
US

IV. Provider business mailing address

ALTURAS DE HATILLO CALLE JARDIN 814
HATILLO PR
00659
US

V. Phone/Fax

Practice location:
  • Phone: 787-218-6032
  • Fax:
Mailing address:
  • Phone: 787-218-6032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: