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General NPI Number Information
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NPI Number | 1588789747
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Entity Type | Organization
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Legal Business Name | FARMACIA LEDIS
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | BO. SABANALLANA CARR. 510 KM 2.1
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City | JUANA DIAZ
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State | PR
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Zip | 00795
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Country | US
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Telephone | 787-837-0824
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 09 BOX 3504
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City | JUANA DIAZ
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State | PR
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Zip | 00795
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Country | US
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Telephone | 787-837-0824
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Fax |
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Authorized Official
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Title or Position | PROPIETARIA
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Name | MISS LYDIA GONZALEZ CINTRON
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Credential |
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Telephone | 787-837-0824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 07F-2035
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License Number State | PR
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