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General NPI Number Information
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NPI Number | 1497972962
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Entity Type | Individual
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Provider Name | MRS. MARIA DE LOURDES VENTURA
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 601 CALLE LODI
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City | SAN JUAN
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State | PR
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Zip | 00924-3844
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Country | US
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Telephone | 787-763-8435
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Fax | 787-764-6492
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Provider Business Mailing Address
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Address Line | PMB 48 PO BOX 2500
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City | TRUJILLO ALTO
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State | PR
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Zip | 00977-2500
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Country | US
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Telephone | 787-763-8435
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Fax | 787-764-6492
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 117
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License Number State | PR
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