Healthcare Provider Details

I. General information

NPI: 1295575777
Provider Name (Legal Business Name): LLUBERES DENTAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

654 AVE LUIS MUNOZ RIVERA STE 1835
SAN JUAN PR
00918-4113
US

IV. Provider business mailing address

654 AVE LUIS MUNOZ RIVERA STE 1835
SAN JUAN PR
00918-4113
US

V. Phone/Fax

Practice location:
  • Phone: 787-585-6574
  • Fax:
Mailing address:
  • Phone: 787-585-6574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MISS JOHANNA ELIZABETH LLUBERES GIL
Title or Position: ADMINISTRADOR
Credential:
Phone: 787-585-6574