Healthcare Provider Details

I. General information

NPI: 1710295159
Provider Name (Legal Business Name): LUCRECIA CARTAGENA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 09/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB LAS MERCEDES CALLE 4 CASA 4A
SALINAS PR
00751-0141
US

IV. Provider business mailing address

PO BOX 141
SALINAS PR
00751-0141
US

V. Phone/Fax

Practice location:
  • Phone: 787-824-8441
  • Fax: 787-844-4130
Mailing address:
  • Phone: 787-824-8441
  • Fax: 787-844-4130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number16455
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: