Healthcare Provider Details

I. General information

NPI: 1275655052
Provider Name (Legal Business Name): IRMA NIDIA LAMBOY-SANCHEZ MEDICAL DOCTOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CONVENIENCIA ST #1402 SUITE 701
SAN JUAN PR
00907
US

IV. Provider business mailing address

CONVENIENCIA ST #1402 SUITE 701
SAN JUAN PR
00907
US

V. Phone/Fax

Practice location:
  • Phone: 787-723-4582
  • Fax: 787-724-5238
Mailing address:
  • Phone: 787-723-4582
  • Fax: 787-724-5238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLIC 05345
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: