Healthcare Provider Details

I. General information

NPI: 1265513287
Provider Name (Legal Business Name): LOURDES BARRERAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 CALLE 13 SW CAPARRA TERRACE
SAN JUAN PR
00921-2015
US

IV. Provider business mailing address

COND. JARDINES DE MONTEHIEDRA APT. # 308
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-793-4254
  • Fax: 787-793-4251
Mailing address:
  • Phone: 787-793-4254
  • Fax: 787-793-4251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number7313
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: