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General NPI Number Information
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NPI Number | 1215884580
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Entity Type | Individual
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Provider Name | LUZ DE BORINQUEN LOPEZ RPHT
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Gender | Female
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Dates
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Enumeration Date | 03/14/2026
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Last Update Date | 03/14/2026
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Provider Practice Location Address
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Address Line | 400 HEALTH PARK BLVD
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32086-5784
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Country | US
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Telephone | 904-819-4320
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Fax | 904-819-4923
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Provider Business Mailing Address
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Address Line | 2867 N 9TH ST
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32084-1867
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Country | US
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Telephone | 904-819-4320
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Fax | 904-819-4923
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | RPT100518
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License Number State | FL
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